Weber H P, Kaltenbrunner W, Heinze A, Steinbach K
I. Medical Department, Hospital Harlaching, Teaching Hospital, University of Munich, Germany.
Eur Heart J. 1997 Mar;18(3):487-95. doi: 10.1093/oxfordjournals.eurheartj.a015270.
A new technique for ablation of atrioventricular nodal reentrant tachycardia, using catheter-directed continuous wave Nd-YAG laser light, 1064 nm, via a novel pin-electrode laser catheter, was applied in 10 patients aged 15-63 years (mean 43 years). A total of 22 laser pulses, 1-5 per patient, at 20 or 30 W, of 10-45 s (mean 27 s) were aimed at the postero-inferior aspect of the tricuspid annulus. In all patients the tachycardia was rendered non-inducible at baseline as well as during orciprenaline administration. The amplitudes of the local atrial potentials diminished from 2.0 +/- 0.5 before to 0.4 +/- 0.4 mV after ablation, atrio-His intervals increased from 73 +/- 7 to 157 +/- 36 ms. Anterograde atrioventricular nodal refractory periods (212 +/- 31 vs 238 +/- 31 ms) and Wenckebach rate (174 +/- 8 vs 167 +/- 8 beats.min-1) did not change significantly (P > 0.05). There were no complications or recurrent arrhythmias in a follow-up of 12-35 (mean 27) months. Anatomically guided laser catheter coagulation of the postero-inferior aspect of the tricuspid valve ring is a safe and effective method for the cure of patients with common atrioventricular reentrant tachycardia.
一种使用新型针电极激光导管，通过导管引导1064nm连续波Nd-YAG激光消融房室结折返性心动过速的新技术应用于10例年龄在15至63岁（平均43岁）的患者。共进行了22次激光脉冲，每位患者1至5次，功率为20或30W，持续10至45秒（平均27秒），靶点为三尖瓣环后下侧。所有患者在基线时以及使用奥西那林期间心动过速均不能被诱发。局部心房电位幅度从消融前的2.0±0.5mV降至消融后的0.4±0.4mV，房室间期从73±7ms增加至157±36ms。房室结前传不应期（212±31ms对238±31ms）和文氏率（174±8次/分钟对167±8次/分钟）无显著变化（P>0.05）。在12至35个月（平均27个月）的随访中无并发症或心律失常复发。解剖学引导下对三尖瓣环后下侧进行激光导管凝固术是治疗常见房室折返性心动过速患者的一种安全有效的方法。
