Huang S K
Division of Cardiovascular Medicine, University of Massachusetts Medical Center, Worcester 01655.
Am Heart J. 1989 Dec;118(6):1317-23. doi: 10.1016/0002-8703(89)90023-9.
Since its introduction in 1985, there have been numerous reports of the use of radio-frequency (RF) current as an alternative energy source for catheter ablation. RF current (frequency range 150 kHz to 1 MHz), when delivered in bipolar mode, causes desiccation of tissue by creating a localized area of heat that results in discrete coagulation necrosis. An equivalent energy source such as direct current (DC) shock can be delivered at lower power (5 to 30 W) and lower voltage (30 to 80 V) for a longer pulse duration (10 to 60 seconds), thus eliminating barotraumatic effects. Because of its high frequency, RF current does not stimulate neuromuscular fibers, and general anesthesia during ablation is not needed. Studies in animals have shown that catheter-delivered RF energy can safely produce permanent complete or partial AV block, necrosis of atrial and ventricular myocardium adjacent to the mitral and tricuspid anuli potentially suitable for ablation of accessory pathways, and discrete lesions in the left and right ventricular myocardium. Recently, investigators from several centers have reported successful ablation of the AV junction (either complete or partial AV block) in patients with refractory supraventricular tachyarrhythmias, ablation of accessory pathways, and ablation of focal ventricular myocardium or a segment of a bundle branch in patients with drug-resistant ventricular tachycardia. Specific modification of AV conduction to cure AV nodal reentrant tachycardia has been successfully attempted. In all studies the application of RF current has not caused any serious complications.(ABSTRACT TRUNCATED AT 250 WORDS)
自1985年引入以来，已有大量关于使用射频（RF）电流作为导管消融替代能源的报道。射频电流（频率范围为150 kHz至1 MHz）在双极模式下传递时，通过产生局部热区导致组织干燥，从而形成离散的凝固性坏死。诸如直流（DC）电击等等效能源可以在较低功率（5至30 W）和较低电压（30至80 V）下传递更长的脉冲持续时间（10至60秒），从而消除气压创伤效应。由于其高频特性，射频电流不会刺激神经肌肉纤维，消融过程中无需全身麻醉。动物研究表明，经导管传递的射频能量可安全地产生永久性完全或部分房室传导阻滞、二尖瓣和三尖瓣环附近心房和心室心肌的坏死，这可能适用于旁路消融，以及在左、右心室心肌中形成离散病变。最近，几个中心的研究人员报告了在难治性室上性快速心律失常患者中成功消融房室交界区（完全或部分房室传导阻滞）、在旁路患者中消融旁路以及在药物难治性室性心动过速患者中消融局灶性心室心肌或束支节段。已经成功尝试通过特异性改变房室传导来治愈房室结折返性心动过速。在所有研究中，射频电流的应用均未引起任何严重并发症。（摘要截短于250字）
