Baszko Artur, Bobkowski Waldemar, Surmacz Rafał, Siwińska Aldona
II Klinika Kardiologii, Uniwersytet Medyczny im. K. Marcinkowskiego, Poznań.
Kardiol Pol. 2011;69(7):739-42.
Successful ablation of atrial or ventricular arrhythmia from aortic sinuses of Valsalva has been well documented with low complication rate. Radiofrequency (RF) ablation of anteroseptal pathway is always challenging for the risk of atrioventricular block. Thus cryoablation is widely accepted approach. We present a 27 year-old patient with WPW syndrome and frequent palpitations referred for cryoablation of anteroseptal pathway. Extensive mapping from high anterseptal region and from noncoronary aortic cusp of aorta revealed a sharp pathway potential but several applications of cryomapping were unsuccessful. Finally, the pathway was permanently ablated with RF energy from noncoronary cusp of aorta. The mapping of aortic valve should be performed during difficult anteroseptal pathway ablation and unsuccessful cryomapping dose not preclude successful RF ablation at the same location.
经主动脉窦成功消融房性或室性心律失常已有充分文献记载，且并发症发生率较低。由于存在房室传导阻滞风险，经射频（RF）消融前间隔旁道一直具有挑战性。因此，冷冻消融是被广泛接受的方法。我们报告一名27岁患有预激综合征（WPW）且频发心悸的患者，前来接受前间隔旁道冷冻消融治疗。对前间隔高位区域和主动脉无冠窦进行广泛标测，发现了明显的旁道电位，但多次冷冻标测均未成功。最后，通过来自主动脉无冠窦的射频能量将旁道永久性消融。在困难的前间隔旁道消融过程中应进行主动脉瓣标测，冷冻标测失败并不排除在同一位置成功进行射频消融。
