Yamabe H, Okumura K, Tabuchi T, Yasue H
Division of Cardiology, Kumamoto University School of Medicine.
Intern Med. 1995 Apr;34(4):233-9. doi: 10.2169/internalmedicine.34.233.
Eighty patients with manifest or concealed Wolff-Parkinson-White (WPW) syndrome underwent catheter ablation of 86 accessory pathways (AP) using radiofrequency current. There are 65 AP located on the left side and 21 on the right side of the heart. The atrioventricular reciprocating tachycardia was previously documented in 77 patients and atrial fibrillation with a rapid ventricular response in 21 patients. Ablation was attempted via a catheter positioned at the atrial aspect of the tricuspid annulus in patients with a right-sided AP and via a catheter positioned in the left ventricle directly below the mitral annulus in patients with a left-sided AP. AP conduction was permanently abolished in 82 of the 86 pathways (95%). The number of radiofrequency current applications for these 82 successfully ablated AP was 7.6 +/- 0.9. Of the 65 left-sided and 21 right-sided AP, 62 (95%) and 20 AP (95%) were successfully ablated, respectively. The current application to the right-sided AP was 16.7 +/- 2.2, which was greater than that to the left-sided one (4.7 +/- 0.6, p < 0.001). No serious complication was observed in any case. Catheter ablation of AP using radiofrequency current is an effective and safe therapeutic modality for patients with symptomatic WPW syndrome.
80例显性或隐匿性预激综合征（WPW）患者接受了经导管射频电流消融86条旁路（AP）。其中65条AP位于心脏左侧，21条位于右侧。77例患者曾记录到房室折返性心动过速，21例患者出现房颤伴快速心室反应。对于右侧AP患者，通过置于三尖瓣环心房侧的导管进行消融；对于左侧AP患者，通过置于二尖瓣环正下方左心室的导管进行消融。86条通路中的82条（95%）AP传导被永久性阻断。这82条成功消融的AP的射频电流应用次数为7.6±0.9次。65条左侧AP和21条右侧AP中，分别有62条（95%）和20条（95%）成功消融。右侧AP的电流应用次数为16.7±2.2次，高于左侧AP（4.7±0.6次，p<0.001）。所有病例均未观察到严重并发症。对于有症状的WPW综合征患者，经导管射频电流消融AP是一种有效且安全的治疗方式。
