Clementy J, Moreau C, Douart H, Coste P, Bricaud H
Départment d'électrophysiologie, hôpital cardiologique, université de Bordeaux II, Pessac.
Arch Mal Coeur Vaiss. 1988 Dec;81(12):1483-90.
Between 1982 and 1987, 70 patients (32 men, 38 women, aged from 45 to 93 years) underwent catheter ablation of His bundle and were followed up for more than 3 months. The disorders treated were atrial fibrillation, flutter of tachycardia (62 cases), junctional tachycardia (7 cases) and refractory atrial extrasystoles (1 case). The overall results were: early failure in 1 case, late death in 3 cases, persistent high degree AV block in 53 cases (75 p. 100), 1st degree AV block in 9 cases (12 p. 100) and failure in 8 cases (13 p. 100). Two techniques were used. In the first 30 patients ablation was performed by tri- or quadripolar catheters with electrodes 10 mm apart (USCI 2943/2854) and localization by an unipolar electrode connected to the negative pole of the defibrillator. The mid-term results in this series were: complete AV block in 20 cases (66 p. 100), partial AV block in 5 cases (17 p. 100) and failure in 17 cases (17 p. 100). In the last 40 patients localization was bipolar and ablation was obtained with simultaneous bipolar leads taken from a Josephson catheter with electrodes 5 mm apart (USCI 8567); the two electrodes recording the highest His bundle potential were connected to the negative pole of the defibrillator. The results in these series were: complete AV block in 33 cases (82 p. 100), partial AV block in 4 cases (11 p. 100) and failure in 3 cases (7 p. 100). Although the two series were not exactly similar, it seems permissible to recommend the second, more convenient technique.
1982年至1987年间，70例患者（32例男性，38例女性，年龄45至93岁）接受了希氏束导管消融术，并进行了超过3个月的随访。治疗的疾病包括心房颤动、心动过速性扑动（62例）、交界性心动过速（7例）和难治性房性期前收缩（1例）。总体结果为：早期失败1例，晚期死亡3例，持续性高度房室传导阻滞53例（75%），一度房室传导阻滞9例（12%），失败8例（13%）。使用了两种技术。在前30例患者中，使用电极间距为10毫米的三极或四极导管（USCI 2943/2854）进行消融，并通过连接到除颤器负极的单极电极进行定位。该组的中期结果为：完全性房室传导阻滞20例（66%），部分性房室传导阻滞5例（17%），失败17例（17%）。在最后40例患者中，采用双极定位，使用电极间距为5毫米的约瑟夫森导管同时获取双极导联进行消融（USCI 8567）；记录最高希氏束电位的两个电极连接到除颤器负极。该组结果为：完全性房室传导阻滞33例（82%），部分性房室传导阻滞4例（11%），失败3例（7%）。尽管两组并不完全相同，但似乎可以推荐第二种更简便的技术。
