Scheinman M M, Laks M M, DiMarco J, Plumb V
Office of Scientific Affairs, American Heart Association, Dallas, TX 75231.
Circulation. 1991 Jun;83(6):2146-53. doi: 10.1161/01.cir.83.6.2146.
Catheter ablative techniques have assumed an increasingly important role in the treatment of patients with drug-refractory cardiac arrhythmias. Catheter ablation of the AV junction is considered the procedure of choice for management of patients without bypass tracts with drug-resistant supraventricular arrhythmias. Catheter techniques have been used with increasing frequency in attempts to ablate accessory AV tracts. These techniques currently appear to be less effective than surgical techniques but involve less morbidity and expense. In some centers, accessory pathway ablation using catheter techniques is the procedure of first choice in selected patients with drug-refractory tachycardia mediated by an accessory pathway. Catheter ablation of ventricular tachycardia should be reserved for patients with mappable ventricular tachycardia who are not candidates for cardiac electrosurgery or insertion of an automatic defibrillator. The development of more flexible catheters and more manageable energy delivery systems holds promise for more effective catheter techniques.
导管消融技术在药物难治性心律失常患者的治疗中发挥着越来越重要的作用。房室结导管消融被认为是治疗无旁路且药物抵抗性室上性心律失常患者的首选方法。导管技术越来越频繁地用于尝试消融房室旁路。目前这些技术似乎不如手术技术有效，但发病率和费用较低。在一些中心，对于某些药物难治性旁路介导的心动过速患者，使用导管技术进行旁路消融是首选方法。室性心动过速的导管消融应仅用于那些有可标测室性心动过速但不适合心脏电外科手术或植入自动除颤器的患者。更灵活的导管和更易于管理的能量输送系统的发展有望带来更有效的导管技术。
