摘要
目的探讨穿房间隔途径导管消融治疗左侧旁路的有效性及安全性。方法选择2007年7月~2014年12月在广东省第二人民医院行导管消融治疗的52例左侧旁路患者,其中23例经主动脉逆行标测消融,29例经静脉穿房间隔心房侧标测消融。比较两组临床特点、手术放电时间及次数、X线曝光时间、手术总时间、手术疗效及安全性。结果穿房间隔组的放电时间及次数、X线曝光时间、手术总时间较经动脉逆行组均明显缩短（p〈0.01）,即刻成功率100%;经主动脉逆行标测消融组有2例需改穿间隔消融成功,即刻成功率91.3%。两组均无并发症。随访（16.5±12.4）个月,共有2例复发经再次消融成功,经动脉逆行组及穿房间隔组各1例,复发率分别为4.3%与3.4%。结论经静脉穿房间隔心房侧左侧旁路消融可行、安全、有效,特别对左前外侧壁旁路消融导管更易定位及消融成功,可作为该旁路的首选消融途径。
Objective To explore the clinical efficacy and safety of catheter ablation of left- sided accessory pathways by transseptal approach. Methods 52 cases of left- sided accessory pathways treated in our hospital from July 2007 to December 2014 were selected and divided into two groups. One group included 23 cases treated by transaortic approach and the other one included 29 cases by transseptal approach. The clinical features,discharge time and frequencies of surgery,x- ray exposure,total operation time,surgical efficacy and security were compared in the two groups. Results Compared with the transaortic group,discharge time and frequencies of surgery,x- ray exposure and total operation time in the transseptal group were significantly decreased（ p 〈 0. 01）. The success rate of primary ablation in the transseptal group was 100%,while the transaortic group was 91. 3% with 2 cases failed but succeeded after shifting to be treated by transseptal approach. There were no complications in the two groups. During a mean follow-up of 16. 5 ± 12. 4 months,2 recurrent cases were ablated successfully by repeated ablation. The transaortic and transseptal groups each had one recurrent case with the recurrent rate of 4. 3% and 3. 4% respectively. Conclusion Transseptal approach is a feasible,safe and effective method for radiofrequency catheter ablation of left- sided accessory pathways. Especially,left anterior accessory pathways are easier to be positioned and ablated successfully. So they are the preferred pathways in transseptal approach.
出处
《现代医院》
2015年第5期20-21,24,共3页
Modern Hospitals
基金
广东省自然科学基金(编号:S2012040006782)
关键词
电生理学
左侧旁路
导管消融
房间隔穿刺术
Electrophysiology
Left-sided accessory pathways
Catheter ablation
Atrial septal puncture
