Arribas Ynsaurriaga F, López Gil M, Ruiz Campa R, Gutiérrez Larraya F, Merino Batres G, García-Cosío Mir F
Servicio de Cardiología, Hospital Universitario de Getafe, Madrid.
Rev Esp Cardiol. 1993 Nov;46(11):765-9.
The permanent form of junctional reciprocating tachycardia is due to accessory pathways with retrograde long conduction times. We report the localization of the atrial insertion of the accessory pathway and successful ablation with radiofrequency in 3 patients. The participation of an accessory pathway in the tachycardia was demonstrated by atrial capture without changes in the sequence, with ventricular stimuli during His bundle refractoriness. The atrial insertion was localized by mapping near the os of the coronary sinus. In all cases one to three radiofrequency pulses applied at this point interrupted the tachycardia. Retrograde conduction through the accessory pathway reappeared in 30 min or earlier in all, with displacement of the point of earliest atrial activation, and tachycardia recurred. Total abolition of accessory pathway conduction and cure of the tachycardia required new radiofrequency applications, that in one case were done in a second procedure.
交界性折返性心动过速的持续性形式是由于具有逆行长传导时间的旁路所致。我们报告了3例患者旁路心房插入部位的定位及射频成功消融情况。通过在希氏束不应期进行心室刺激时心房夺获且顺序无改变，证实了旁路参与心动过速。通过在冠状窦口附近标测来定位心房插入部位。在所有病例中，在此部位施加一至三个射频脉冲可中断心动过速。所有患者在30分钟或更早时间内旁路逆行传导再次出现，最早心房激动点移位，心动过速复发。要完全消除旁路传导并治愈心动过速，需要再次进行射频应用，其中1例患者在第二次手术中完成。
