摘要
比较在心房扑动 (AFL)时、冠状静脉窦口 (CSO)或低外侧右房 (LRA)起搏下和窦性心律 (简称窦律 )下消融Ⅰ型AFL的优缺点。 48例阵发性AFL随机分为AFL消融组、起搏消融组和窦律消融组 ,对下腔静脉口和三尖瓣环之间的后峡部作线性消融 ,终点为后峡部双向传导阻滞。比较三组患者的电生理参数、急性成功率和远期效果。结果 :三组均达到后峡部双向阻滞 ,随访 2 1.8± 5 .6个月无AFL复发。AFL消融组在AFL终止后均不能达到后峡部双向阻滞 ,需继续在起搏下消融。起搏消融组的操作和曝光时间、放电能量和次数小于其他两组 (P <0 .0 5 )。三组在后峡部双向阻滞后记录局部心房双电位的阳性率为 37.5 %。结论 :①对Ⅰ型AFL采用窦律消融法、起搏消融法和AFL消融法都能取得满意的近远期疗效。②后峡部双向传导阻滞是保证近远期疗效的重要消融终点。③在消融部位标测到双电位可作为消融有效的指标 ,但不能代替后峡部双向阻滞作为消融终点。④起搏消融法的操作和曝光时间、放电能量和次数明显少于在AFL和窦律下消融 。
Comparing following three radiofrequency catheter ablation (RFCA) methods for patients (pts) with type Ⅰ atrial flutter (AFL):RFCA during AFL,RFCA during pacing in coronary sinus/low lateral right atrium and RFCA during sinus rhythm.Establishing a practical RFCA procedure for AF.Fortyeight pts were divided randomly into three groups:AFL ablation,pace ablation and sinus ablation.The posterior isthmus between inferior vena vava and tricuspid valve annulus was the ablation target.Ablation end point was posterior isthmus double direction block.Pts were followedup in clinics or by inquisition for more than six months.Results: All pts have got the end point of posterior isthmus complete block without AFL recurrence in 21.8±5.6 month's followup.In AFL ablation group,there was not one case who showed posterior isthmus complete block after AFL was terminated by ablation.The procedure time,fluoroscopy time and energy delivery time in pace ablation group were significantly shorter than those in other two groups P<0.05).Positive double potential along the ablation line was recorded in only 37.5% pts after successful ablation.Conclusions: ①All three ablation methods (AFL ablation,pace ablation and sinus ablation) could be used to get a satisfactory longterm effect in the treatment of AFL.②The most important ablation end point is the complete isthmus conduction block.③Double potential mapping during procedure can not replace the posterior isthmus block as an ablation end point.④Pace ablation method is superior to both AFL ablation method and sinus ablation method.It could be used as a regular AFL ablation procedure.[Chinese Journal of Cardiac Pacing and Electrophysiology,2000,14(2):98～100] Type Ⅰ atrial flutter Catheter ablation,radiofrequency current Ablation methodology
出处
《中国心脏起搏与心电生理杂志》
2000年第2期98-100,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
