Kobayashi Y, Ino T, Miyauchi Y, Kawaguchi N, Ogura H, Ohmura K, Ohara T, Tadera T, Endoh Y, Yashima M, Kuruma A, Onodera T, Saitoh H, Atarashi H, Katoh T, Kishida H, Hayakawa H
First Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Nihon Ika Daigaku Zasshi. 1997 Dec;64(6):546-65. doi: 10.1272/jnms1923.64.546.
Closed-chest transcatheter electrical ablation (catheter ablation) has been applied to various supraventricular and ventricular tachyarrhythmias as a radical therapeutic technique since its introduction in 1982. Currently, it has become a first line therapy for supraventricular tachyarrhythmias except atrial fibrillation and uncommon types of atrial flutter. We first carried out the ablation procedure in 1991 for the treatment of ventricular tachycardia. Up to February 1997, a total of 187 patients underwent catheter ablation in our institution. The aims of this study are to demonstrate our results of catheter ablation in the early 5 years and to show the usefulness of this new curative method. Successful results were obtained in 168 of 187 patients (overall final success rate: 89.8%). The success rates of each category of tachyarrhythmias were 100/105 patients (95%) with WPW syndrome, 41/46 (89%) with atrioventricular nodal reentrant tachycardia, 7/10 (70%) with atrial flutter, 4/4 (100%) with atrial tachycardia, 2/2 (100%) with medically refractory atrial fibrillation, 13/15 (85%) with idiopathic ventricular tachycardia and 3/7 (43%) with sustained ventricular tachycardia associated with structural heart disease, respectively. Complications that required invasive treatments were observed in 3 patients (2 hemopericardium and 1 complete atrioventricular block). Our results indicate that catheter ablation is highly effective in most categories of tachyarrhythmias and can be applied safely without lethal complications.
自1982年引入以来,闭合式经导管电消融术(导管消融术)已作为一种根治性治疗技术应用于各种室上性和室性快速心律失常。目前,它已成为除房颤和罕见类型房扑之外的室上性快速心律失常的一线治疗方法。我们于1991年首次开展消融手术以治疗室性心动过速。截至1997年2月,我院共有187例患者接受了导管消融术。本研究的目的是展示我们在最初5年的导管消融术结果,并表明这种新的治愈方法的有效性。187例患者中有168例获得成功结果(总体最终成功率:89.8%)。各类快速心律失常的成功率分别为:预激综合征患者100/105例(95%),房室结折返性心动过速患者41/46例(89%),房扑患者7/10例(70%),房性心动过速患者4/4例(100%),药物难治性房颤患者2/2例(100%),特发性室性心动过速患者13/15例(85%),与结构性心脏病相关的持续性室性心动过速患者3/7例(43%)。3例患者出现了需要侵入性治疗的并发症(2例心包积血和1例完全性房室传导阻滞)。我们的结果表明,导管消融术对大多数类型的快速心律失常非常有效,并且可以安全应用而无致命并发症。