Willems S, Borggrefe M, Shenasa M, Hindricks G, Haverkamp W, Chen X, Seidl K, Breithardt G
Medizinische Klinik und Poliklinik (Kardiologie/Angiologie), Westfälische Wilhelms-Universität Münster.
Z Kardiol. 1992 Oct;81(10):560-4.
Catheter ablation using radiofrequency or direct current energy was performed in 19 consecutive patients with concealed accessory pathways. Four patients developed manifest preexcitation for the first time following ablation. The concealed accessory pathways of these four patients were localized at right lateral, left posteroseptal, left posterolateral, and left lateral sites, respectively. In two patients, manifest preexcitation developed immediately after attempted ablation. In the other two patients, preexcitation occurred after 4 and 14 days. Electrophysiologic testing revealed in all four patients that the origin of manifest preexcitation corresponded to the site of the concealed pathway. Successful catheter ablation using radiofrequency current was performed in three patients. One patient preferred surgical interruption of the accessory pathway. The reason for this sudden emergence of preexcitation of these patients with only retrograde conducting pathways remains to be investigated. The anterograde conduction capacity might have been modified by damaging the site of the accessory pathway insertion.
对19例隐匿性旁路患者进行了射频或直流电能量导管消融。4例患者在消融后首次出现显性预激。这4例患者的隐匿性旁路分别位于右外侧、左后间隔、左后外侧和左侧部位。2例患者在尝试消融后立即出现显性预激。另外2例患者分别在4天和14天后出现预激。电生理检查显示，所有4例患者显性预激的起源均与隐匿性旁路部位相对应。3例患者通过射频电流成功进行了导管消融。1例患者选择手术切断旁路。这些仅有逆向传导通路的患者预激突然出现的原因仍有待研究。可能是通过损伤旁路插入部位而改变了前向传导能力。
