Wang L, Hu D, Ding Y
Department of Cardiology, First Teaching Hospital, Beijing Medical University, China.
Int J Cardiol. 1993 Dec 15;42(2):155-60. doi: 10.1016/0167-5273(93)90085-u.
Tachycardias mediated by atrioventricular accessory pathways, which are refractory to antiarrhythmic drug therapy have been treated both by surgery and by catheter ablation with high energy direct current shock. These procedures have variable success rates and substantial associated morbidity and mortality. Radiofrequency ablation, a newer, low-energy technique is potentially safer and more effective. Of 110 patients with 117 accessory pathways, 101 were located on the left side and 16 on the right. Accessory pathway conduction was abolished permanently in 101 (91.8%) patients. VA conduction dissociation and VA decremental conduction were found in 88 and 13 successful patients, respectively. Four (3.9%) patients with decremental VA conduction suffered arrhythmia recurrence after a mean of 8 months follow-up. Complications developed in two patients including right femoral vein thrombosis and left ventricular insufficiency. There were no deaths from the procedure. We conclude that radiofrequency current ablation is a safe and effective interventional modality for patients with symptomatic tachycardias mediated by atrioventricular accessory pathways.
由房室旁路介导的心动过速，对抗心律失常药物治疗无效，已通过手术和高能直流电休克导管消融进行治疗。这些手术成功率各不相同，且伴有大量相关的发病率和死亡率。射频消融是一种更新的低能量技术，可能更安全、更有效。在110例有117条旁路的患者中，101条位于左侧，16条位于右侧。101例（91.8%）患者的旁路传导被永久消除。分别在88例和13例成功患者中发现室房传导分离和室房递减传导。4例（3.9%）有室房递减传导的患者在平均8个月的随访后出现心律失常复发。两名患者出现并发症，包括右股静脉血栓形成和左心室功能不全。该手术无死亡病例。我们得出结论，射频电流消融对于有症状的由房室旁路介导的心动过速患者是一种安全有效的介入方式。
