摘要
阐明合并永存左上腔静脉畸形 (PLSVC)的快速心律失常经导管射频消融治疗的方法学和特殊性。自 1 997年 6月至 2 0 0 1年 6月共对 1 3例合并PLSVC的快速心律失常进行了经导管射频消融治疗 ,其中房室结折返性心动过速 (AVNRT) 7例、左侧旁道 3例 ;右侧旁道、房性心动过速 (简称房速 )和室性心动过速 (简称室速 )各 1例。冠状静脉窦标测电极均常规经左锁骨下静脉放置 ,其中 9例进行了冠状静脉窦造影 ,3例左侧旁道中的 2例采用了经主动脉逆行法消融、1例采用穿间隔法在二尖瓣环心房侧消融 ,7例AVNRT中的 5例采用Swartz鞘管支持消融导管实现稳定贴靠。消融成功率 1 0 0 % ,无并发症。结论 :多种快速心律失常可合并PLSVC ,经导管射频消融仍有较高的成功率 ,但是在冠状静脉窦电极放置、冠状静脉窦标测和AVNRT消融的方法学上有一定特殊性。
The aim of the study is to elucidate the speciality of radiofrequency catheter ablation(RFCA) for tachycardias in patients with persistent left superior vena cava(PLSVC).From June 1997 to June 2001,RFCA for tachycardias in patients with persistent left superior vena cava was carried out in 13 patients(pts),including 7 pts with atrioventricular nodal reentrant tachycardia(AVNRT),3 pts with left sided accessory atrioventricular pathway(AP),and each in 1 patient with right sided AP,atrial tachycardia and ventricular tachycardia,respectively.Coronary sinus access through the left subclavian vein was performed in each patient and coronary sinus angiography was also carried out in 9 out of the 13 pts.RFCA for 3 pts with left sided APs was accomplished through aortic retrograde approach in 2 pts and through transseptal approach in 1 pts.Swartz sheath support technique was introduced necessarily in 5 out of the 7 pts with AVNRT to stabilize the ablation catheter.The successful rate of 100% was achieved without any complication.Conclusions:PLSVC could coexist with tachycardias with different mechanism.Even though RFCA for tachycardias with PLSVC showed specialities in cathter manipulation,mapping and ablation,high successful results could achieved by experienced physician.
出处
《中国心脏起搏与心电生理杂志》
2001年第5期324-326,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
