Kriatselis Charalampos, Roser Mattias, Min Tang, Evangelidis Georgios, Höher Martin, Fleck Eckart, Gerds-Li Hong
Department of Cardiology, German Heart Institute Berlin, Augustenburgerplatz 1, Berlin 13353, Germany.
Europace. 2008 Jun;10(6):698-704. doi: 10.1093/europace/eun091. Epub 2008 Apr 10.
The purpose of this study was to evaluate a retrograde approach for radiofrequency (RF) ablation of ectopic atrial tachycardias (EATs) with an early atrial activation at the His site.
This study included 12 patients with EAT. During tachycardia, earliest atrial activation was recorded at the His site at a standard catheter setting. Activation mapping was performed in the right atrium and along the mitral annulus and at the aortic root after retrograde insertion of the ablation catheter over the ascending aorta. In five patients, earliest atrial activation was recorded at the mitral annulus (in two patients at the superior-lateral annulus and in three patients at the inferior-medial annulus). In four of these patients, EAT could be successfully treated by RF ablation through the retrograde approach, whereas in one patient, a transseptal puncture was performed in order to achieve a stable catheter position. In seven patients, RF ablation at the non-coronary aortic sinus eliminated the tachycardia. During a follow-up period of 14 +/- 8 months, there was no tachycardia recurrence.
In patients with EATs and early atrial activation at the His site, tachycardia may arise in the non-coronary aortic sinus or from the mitral annulus. Radiofrequency energy ablation can be performed through a retrograde approach in the majority of these patients and is safe and effective in eliminating this type of tachycardia.
本研究旨在评估一种逆行方法，用于对希氏束部位出现早期心房激动的异位房性心动过速（EAT）进行射频消融。
本研究纳入了12例EAT患者。在心动过速发作期间，在标准导管设置下，最早的心房激动记录于希氏束部位。在经升主动脉逆行插入消融导管后，在右心房、沿二尖瓣环及主动脉根部进行激动标测。5例患者最早的心房激动记录于二尖瓣环（2例位于上外侧环，3例位于下内侧环）。其中4例患者通过逆行方法进行射频消融成功治疗了EAT，而1例患者进行了经房间隔穿刺以获得稳定的导管位置。7例患者在无冠窦进行射频消融消除了心动过速。在14±8个月的随访期内，无心动过速复发。
对于希氏束部位出现早期心房激动的EAT患者，心动过速可能起源于无冠窦或二尖瓣环。在大多数此类患者中，可通过逆行方法进行射频能量消融，且在消除此类心动过速方面安全有效。
