Fontaine G, Frank R, Tonet J, Rougier I, Farenq G, Grosgogeat Y
Service de Rythmologie et de Stimulation Cardiaque, Hôpital Jean Rostand, Ivry, France.
Am J Cardiol. 1989 Dec 5;64(20):83J-86J. doi: 10.1016/0002-9149(89)91207-1.
The fulguration procedure was originally introduced for the treatment of supraventricular arrhythmias by a pervenous interruption of His bundle conduction. This procedure has been extended to the treatment of almost any cardiac arrhythmia resistant to antiarrhythmic drug therapy. Recent results suggest that ablation could be selectively applied to the site of abnormal conduction. Overall results obtained at the Jean Rostand Hospital are reported for a series of 104 patients ranging in age from 14 to 83 years with atrial, junctional and ventricular tachycardias. The follow-up extends up to 65 months. Clinical efficacy, defined as a control of the arrhythmias by fulguration used alone or in association with drug therapy that was previously ineffective, lead to a success rate ranging from 80 to 85%. Mortality was less than 10% in the worst situation (chronic resistant ventricular tachycardia). Mortality was always related to inappropriate protocols. Therefore, fulguration, which was originally reserved to treat the most difficult cases, is now considered for non-life-threatening but incapacitating arrhythmias. Despite these results the technique is not simple. Fulguration should be performed by groups knowledgeable in electrophysiology and with expertise in high voltage electricity and biophysics.
电灼术最初是通过经静脉中断希氏束传导来治疗室上性心律失常的。该手术已扩展到治疗几乎任何对抗心律失常药物治疗无效的心律失常。最近的结果表明，消融可选择性地应用于异常传导部位。本文报告了让·罗斯唐医院对104例年龄在14至83岁之间患有房性、交界性和室性心动过速患者的一系列研究结果。随访时间长达65个月。临床疗效定义为单独使用电灼术或与先前无效的药物治疗联合使用来控制心律失常，成功率在80%至85%之间。在最糟糕的情况下（慢性难治性室性心动过速）死亡率低于10%。死亡率总是与不恰当的治疗方案有关。因此，电灼术最初只用于治疗最困难的病例，现在也被考虑用于治疗虽不危及生命但使人衰弱的心律失常。尽管有这些结果，但该技术并不简单。电灼术应由精通电生理学、具备高电压电学和生物物理学专业知识的团队来进行。
