Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School; Clinical Cardiac Electrophysiology Fellowship; Ventricular Arrhythmia Program.
Card Electrophysiol Clin. 2020 Sep;12(3):357-369. doi: 10.1016/j.ccep.2020.05.001. Epub 2020 Jun 27.
Supraventricular arrhythmias are the most common cardiac arrhythmias encountered; however, it is uncommon that supraventricular tachycardias require percutaneous epicardial access for successful mapping and ablation. There are particular scenarios where epicardial access and ablation should be considered. Certain accessory pathways particularly in the posteroseptal region may require epicardial access for successful ablation. These pathways may also be approached from within the coronary sinus system. In addition, tachycardias near the phrenic nerve in the right atrium or left atrium may require epicardial access for successful ablation or to allow displacement of the phrenic nerve facilitating safe catheter ablation.
室上性心律失常是最常见的心律失常；然而，需要经皮心外膜途径成功进行标测和消融的室上性心动过速并不常见。有一些特殊情况需要考虑心外膜途径和消融。某些特殊的旁路，特别是在后间隔区域，可能需要心外膜途径才能成功消融。这些旁路也可以通过冠状窦系统进入。此外，右心房或左心房靠近膈神经的心动过速可能需要心外膜途径来成功消融或使膈神经移位，以方便安全的导管消融。
