Viteri M, Vergara I, Cambón A M, González R
Departamento de Enfermedades Cardiovasculares, Pontificia Universidad Católica, Santiago, Chile.
Rev Med Chil. 1998 Feb;126(2):169-76.
Accessory pathways are muscular connections between auricles and ventricles, present in different points of mitral and tricuspid annuluses. These pathways participate in 50% of paroxysmal supraventricular tachycardias and the definitive cure of the arrhythmia is their ablation.
To report our experience in patients with right accessory pathways.
Fifty consecutive patients treated between 1990 and 1996 are reported. Eight had a history of syncope, two had a diagnosis of Ebstein disease and 36 had a pre-excitation in the surface electrocardiogram.
Fifty four accessory pathways were identified, since four patients had two pathways. Twenty four pathways were posteroseptal, 15 were lateral, 9 were medioseptal and 6 were anteroseptal. One patient had also a nodal reentry tachycardia. Fulguration was attempted in 39 patients and it was finally successful in 32. Three patients required more than one session. There were six relapses and all were successfully ablated in a second session. A mean of 28 radiofrequency applications were done (range 1-76), mean laboratory time was 6 hours and mean radioscopy time was 70 min. Four patients had a transient atrioventricular conduction blockade.
Radiofrequency ablation of accessory pathways has a high degree of success and a low rate of complications.
附加旁道是心房与心室之间的肌肉连接，存在于二尖瓣和三尖瓣环的不同部位。这些旁道参与50%的阵发性室上性心动过速，心律失常的根治方法是对其进行消融。
报告我们在右附加旁道患者中的经验。
报告了1990年至1996年间连续治疗的50例患者。8例有晕厥病史，2例诊断为埃布斯坦病，36例体表心电图有预激表现。
共识别出54条附加旁道，因为4例患者有两条旁道。24条旁道位于后间隔，15条位于外侧，9条位于中间隔，6条位于前间隔。1例患者还患有房室结折返性心动过速。对39例患者尝试进行电灼，最终32例成功。3例患者需要进行不止一次手术。有6例复发，均在第二次手术中成功消融。平均进行28次射频应用（范围1 - 76次），平均手术时间为6小时，平均透视时间为70分钟。4例患者出现短暂房室传导阻滞。
附加旁道的射频消融成功率高，并发症发生率低。
