Matsunaga Y, Mukai K, Misaki T, Ichihashi T, Shinagawa M, Iwa T
Nihon Kyobu Geka Gakkai Zasshi. 1989 Jun;37(6):1083-7.
Three cases with ectopic atrial tachycardia and two cases with atrial flutter (AF), unresponsive to drugs, are described clinically and electrophysiologically. The three patients of ectopic atrial tachycardia were treated by surgical removal of ectopic focus and cryocoagulation of the adjacent area, not using cardiopulmonary bypass. All of them have been in sinus rhythm and had shown no tachycardia since the operation. In one patient of AF, cryosurgical ablation around the atrioventricular (AV) node and His bundle has prevented AF without AV block. Another patient of AF underwent cryoablation around the orifice of the coronary sinus, which was the earliest activation area during AF in endocardial mapping. In this patient, AF reappeared, so cryoablation around the AV node and His bundle was performed. His heart rate decreased to 120 beat/min from 270 beats/min during AF and a radiofrequency pacemaker (Atricon) was implanted to interrupt the remaining AF. This cryosurgical procedure is successful to modify and preserve AV conduction.
临床和电生理描述了3例异位房性心动过速及2例对药物无反应的心房扑动（AF）病例。3例异位房性心动过速患者通过手术切除异位灶并对相邻区域进行冷冻凝固治疗，未使用体外循环。自手术以来，他们均维持窦性心律，未再出现心动过速。1例AF患者在房室（AV）结和希氏束周围进行冷冻消融，预防了AF且未出现房室传导阻滞。另1例AF患者在冠状窦口周围进行冷冻消融，冠状窦口是心内膜标测时AF最早激动区域。该患者AF复发，因此在AV结和希氏束周围进行冷冻消融。其心率在AF期间从270次/分钟降至120次/分钟，并植入了射频起搏器（Atricon）以中断残余的AF。这种冷冻手术方法成功地改善并保留了房室传导。
