摘要
目的总结射频导管消融进行心房 肺静脉和 /或上腔静脉 (合称大静脉 )电隔离治疗阵发性心房颤动 (房颤 )的并发症。方法顽固性阵发性房颤患者 89例 ,在环状标测电极导管指导下行大静脉的射频导管消融电隔离治疗 ,分析出现的各种并发症。结果 89例病人共接受电隔离治疗 10 3次 ,隔离大静脉 2 30根 ,其中肺静脉 2 0 7根 ,上腔静脉 2 3根。出现并发症 10例 ,其中严重迷走神经反射导致的一过性三度房室阻滞引起的晕厥发作 2例 ,脑卒中 2例 ,肺静脉狭窄 4例 (狭窄程度 >5 0 % ) ,术后少量心包积血 2例 ,并发症的总发生率为 11%。结论射频导管消融进行心房 肺和 /或上腔静脉电隔离治疗阵发性房颤可出现各种并发症 ,多数并发症可通过采取相应的措施使之减少或避免 ,其中肺静脉狭窄和脑卒中为最棘手的并发症 ,应予以高度重视。
Objective Electrical isolation of pulmonary veins (PVs) or superior vena cava (SVC) to treat paroxysmal atrial fibrillation (PAF) has become an established treatment modality. However,one principal limitation of this technique is the risk of complications.The complications of atrium-pulmonary vein (or superior vena cava) electrical isolation in our center were reported, and the potential causes and preventive measures were analyzed. MethodsPatients with drug-resistant PAF were included. Guided by circular mapping catheter, radiofrequency lesions were applied around the circumference of the targeted veins at the ostium until the achievement of electrical disconnection between the atria and veins. ResultsEighty-nine patients underwent pulmonary vein ablation for PAF, and 230 veins were targeted. Complications occurred in ten patients (11%), including one episode of sudden onset of complete AV block with over 10 seconds asystole in 2, cerebral embolism in 2, moderate PV stenosis in 4, and pericardial effusion in 2. ConclusionElectrical isolation of PV from the left atrium by radiofrequency catheter ablation technique is effective in preventing AF recurrence, but could be associated with serious complications. Among them the stroke caused by cerebral embolism and the pulmonary vein stenosis may be the most important complications.
出处
《中华心律失常学杂志》
2004年第1期48-50,共3页
Chinese Journal of Cardiac Arrhythmias
