应用心腔内超声指导局灶性心房颤动的射频消融.pdfVIP

·l4O· }‘国心晴起搏与心屯生理杂志 1999年 I3摩 3期 【 。一c } 厶 应用心腔内超声指导局灶性心房颤动的射频消融 卿，、 ‘1f 商丽华 胡大 成军 杨新春 张建军 吴永全 李宜富 王明生 摘要 探讨在心腔由超声(ICE)导引F对局灶性心房觑动(简称房颤)行射频消融治疗的可行性和安全性 选择4 例阵发性房颤而无器质性心脏病的患者，在ICE指导 F根据电生理检查的定位结果分别在左房的 上肺静脉、 上肺静脉硬右房终末嵴上部进行射频消融。消融能量为30 w，消融温度为∞ 、，放电时『日1 87--I20 s。结果：右房内 超声均町在单幅影像 r动态显示卵圆窝、主动脉、左房，穿刺房间隔时可避免误穿主动脉或穿刺针过浑穿破先房。 左房内超声可显示肺静脉及其分支的内部结构以及导管与内壁的贴靠紧密与稳定程度。1例术中房颤终止，术后 1 天复发；2例消融后房早消失，随游一周无房颤复发；1例术中消融后可诱发房颤但随访半年无房颤发作 结-它：在 ICE导引下对局灶性房颤进 丁射频消融，能增加安全性和可靠性，是 种较有前途的方法。 关蕾词局灶性}!k 导管消融射频电流 巴望! 强可哥 f商而呜， 。 RadiOfrequency ANation of Focal Atrial Fibrillation Under the Guidance Of Intracardiac Echocardiography Shang Lihua，Hu Dayi，Guo Chengiun tet al (Department of Cardiology，Beijing Red Cross Chaoyang Hospital，Capital University of Medical Sciences，BeijIng，l00020) Abstract This study tested the feasibility and safety of radiofrequency(RF catheter ablation in eliminating focal atrial fibril Jatkm (AF)under the guidance of intracardiac echocardiograpby(ICE)．Four paHenrs wltb parox3 sma】 AF and normal heart underwent RF catheter ablation in left and right pulmonary veins and upper portion of cristal terminalis respectively under ICE．Radiofrequency energy was delive red at 30 W ，temperature 6OC，duration of 87 — — 120 seconds．Results：AF was terminated during procedure and recurred next day in one case．The premature atri al complexes disappeared during procedure and no recurrence for one week in two cases．AF could initiated after ab—— latJon hut no symptoItmtJc recurrence