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|本期目录/Table of Contents|

永存左上腔静脉并发室上性心动过速的射频消融治疗

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第4期
页码:
483-485,495
栏目:
临床研究
出版日期:
2012-08-25

文章信息/Info

Title:
Radiofrequency catheter ablation of superior ventricular tachycardia in patients with persistent left superior vena cava
作者:
杨桂棠王祖禄梁延春于海波李世倍金志清韩雅玲
(沈阳军区总医院心内科,辽宁 沈阳 110840)
Author(s):
YANG Gui-tang WANG Zu-lu LIANG Yan-chun YU Hai-bo LI Shi-pei JI Zhi-qing HAN Ya-ling
(Department of Cardiology, General Hospital, Shenyang Military Area Command, Shenyang 110840, Liaoning, China) )
关键词:
永存左上腔静脉心动过速室上性消融射频导管
Keywords:
persistent left superior vena cava superior ventricular tachycardia radiofrequency catheter ablation
分类号:
R541.71
DOI:
-
文献标识码:
A
摘要:
目的:探讨永存左上腔静脉(PLSVC)并发室上性心动过速(SVT)的射频消融策略。方法: 2008年6月~2011年6月在我科行射频消融的SVT患者1 460例, 17例并发PLSVC。其中房室结折返性心动过速(AVNRT)8例,左侧隐匿性旁路伴房室折返性心动过速(AVRT)6例,阵发性房颤(PAF)3例。结果: 17例患者均经左锁骨下静脉穿刺成功,并放置冠状窦电极,8例AVNRT患者经房室结改良成功;6例左侧隐匿性旁路,4例经主动脉逆行途径消融,2例经房间隔穿刺,在二尖瓣心房侧进行旁路消融;3例PAF患者行房间隔穿刺后行环肺静脉电隔离。消融成功率100%,无手术并发症。结论: PLSVC并发SVT,导管消融治疗仍有较高的手术成功率和较低的手术并发症,但在左锁骨下静脉穿刺的识别、导管消融的技巧及手术并发症的防治方面仍有其特殊性。
Abstract:
AIM:To discuss the strategy of radiofrequency catheter ablation (RFCA) of superior ventricular tachycardia (SVT) in patients with persistent left superior vena cava (PLSVC). METHODS: From June 2008 to June 2011, 17 patients with PLSVC and SVT underwent RFCA, including AV node modification (eight patients), left accessory pathway (six patients) and paroxysmal atrial fibrillation (three patients). RESULTS: Coronary sinus was accessed through left subclavian vein in all 17 cases. AV node modification was performed in eight patients. Four patients with left-side accessory pathway were ablated through aortic retrograde approach and the other two patients with left-side accessory pathway were ablated through transseptal approach. Three patients with PAF were ablated through circumferential pulmonary vein isolation after atrium septum puncture. The success rate was 100% and no complications occurred. CONCLUSION: Despite the high success rate and low complication rate of RFCA for patients with PLSVC and SVT, special attention should be paid to the puncture of PLSVA, performance of ablation and prevention of complications.

参考文献/References

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[3]木胡牙提,程祖亨,马依彤,等.房室结折返性心动过速与房室折返性心动过速的冠状静脉窦形态对照研究[J].中华心律失常杂志,2002,6(3):164-165.

[4]董建增,马长生,刘 旭,等.合并永存左上腔静脉畸形的快速心律失常的经导管射频消融治疗[J].中国心脏起搏与电生理杂志,2001,15(5):324-326.

[5]刘少稳,金 哲,赵学中.起源于永存左上腔静脉阵发性心房颤动射频导管消融治疗一例[J].中华心血管病杂志,2005,33(11):1047.

[6]Tsutsui K,Ajiki K,Fujiu K.Successful catheter ablation of atrial tachycardia and atrial fibrillation in persistent left superior vena cava[J].Int Heart J,2010, 51(1):72-74.

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[8]王新华,刘 旭,施海峰,等.永存左上腔静脉起源心房颤动消融致延迟性心脏压塞一例[J].中国介入心脏病学杂志,2010, 1(2):110-111.

备注/Memo

备注/Memo:
收稿日期:2012-02-03.基金项目:辽宁省自然科学基金项目资助(22102250) '通讯作者:王祖禄,主任医师,主要从事心电生理的诊治研究Email:wangzl@medmail.com.cn 作者简介:杨桂棠,博士Email:yanggt1104@sina.com
更新日期/Last Update: 2012-07-20