Smith R T, Gillette P C, Massumi A, McVey P, Garson A
J Am Coll Cardiol. 1986 Aug;8(2):385-90. doi: 10.1016/s0735-1097(86)80055-9.
Five patients with medically refractory incessant supraventricular tachycardia due to a posterior septal, slowly conducting accessory connection underwent transcatheter closed chest ablative treatment. The tachycardia characteristics were consistent with the permanent form of junctional reciprocating tachycardia. In each patient the ablative attempts resulted in independent interruption of either the anterograde limb (atrioventricular node-His bundle conduction) or the retrograde limb (accessory connection) of the tachycardia circuit. Permanent retrograde pathway ablation was achieved in only one patient and followed separate permanent transcatheter His bundle ablation. In three of the other four patients the ablation attempt caused temporary interruption of retrograde conduction. Each patient had improved control of tachycardia related to the ablation attempt. Of the five patients, four required pacemaker implantation. With further refinements, selective ablation of the retrograde limb of the tachycardia circuit may be possible. This experience confirms the anatomic independence of the anterograde and retrograde limbs of the tachycardia circuit.
五例因后间隔缓慢传导旁路导致药物难治性持续性室上性心动过速的患者接受了经导管闭式胸腔消融治疗。心动过速的特征与永久性交界性折返性心动过速一致。在每例患者中，消融尝试均导致心动过速环路的前向支（房室结-希氏束传导）或逆向支（旁路连接）独立中断。仅1例患者成功实现了永久性逆向径路消融，随后进行了单独的永久性经导管希氏束消融。在其他4例患者中的3例，消融尝试导致逆向传导暂时中断。每例患者与消融尝试相关的心动过速控制均得到改善。5例患者中有4例需要植入起搏器。随着进一步改进，可能实现对心动过速环路逆向支的选择性消融。这一经验证实了心动过速环路前向支和逆向支在解剖学上的独立性。
