Sadoul N, de Chillou C, Aliot E
Département de cardiologie, Hôpital central, CHRU de Nancy.
Arch Mal Coeur Vaiss. 1993 Mar;86(3):307-12.
Radiofrequency catheter ablation is a modern radical treatment of the Wolff-Parkinson-White (WPW) syndrome. The authors report their experience of this method in 30 consecutive patients (12 women, 18 men, mean age 34.2 +/- 13 years, range 14 and 63 years) with the WPW syndrome poorly controlled by antiarrhythmic therapy in 27 out of 30 cases. An average of 10.1 applications (1-33) was necessary to suppress anterograde and retrograde conduction in 26 of the 30 patients during the first session (87% success rate). At the time of effective ablation, the average atrioventricular interval was 41 ms (35-55) and in the two patients with a retrograde Kent bundle, the average ventriculoatrial interval was 72 ms (70 and 75 ms). The average duration of the procedure was 3.5 hours (45 mins to 7 hours) with an average fluoroscopy time of 61.6 minutes (9-182 minutes). There were four complications: one pneumothorax, one subacute femoral arterial obstruction and in two patients with a left Kent bundle, one TIA which regressed within 1 hour and one hemiplegia which regressed in 24 hours. After an average follow-up period of 8.3 months (2-16 months) the 26 patients are asymptomatic without any treatment. Radiofrequency catheter ablation therefore seems to be an effective method with a low morbidity for the radical treatment of symptomatic or high risk WPW syndromes.
射频导管消融术是治疗预激综合征(WPW综合征)的一种现代根治方法。作者报告了他们对30例连续患者(12例女性,18例男性,平均年龄34.2±13岁,年龄范围14至63岁)采用该方法的经验,其中30例中有27例患者的WPW综合征经抗心律失常治疗效果不佳。在第一次治疗期间,30例患者中的26例(成功率87%)平均需要进行10.1次(1 - 33次)操作来抑制前传和逆传传导。有效消融时,平均房室间期为41毫秒(35 - 55毫秒),在2例有逆传肯特束的患者中,平均室房间期为72毫秒(70和75毫秒)。手术平均持续时间为3.5小时(45分钟至7小时),平均透视时间为61.6分钟(9 - 182分钟)。出现了4例并发症:1例气胸,1例亚急性股动脉阻塞,在2例有左肯特束的患者中,1例短暂性脑缺血发作在1小时内缓解,1例偏瘫在24小时内缓解。平均随访8.3个月(2 - 16个月)后,26例患者未经任何治疗均无症状。因此,射频导管消融术似乎是一种治疗有症状或高危WPW综合征的有效方法,且发病率较低。