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关键词：心房扑动；峡部；导管消融，射频电流
摘要 对比观察射频消融右房后位峡部和间隔峡部治疗心房扑动(简称房扑)两种方法的疗效。41例房扑患者随机分为后位峡部组(18例)和间隔峡部组(23例)，消融线径分别为三尖瓣环—下腔静脉和三尖瓣环—欧氏嵴。成功消融终点为房扑不能诱发和峡部呈完全性双向阻滞。结果：40例消融成功(97.6%)，无并发症。后位峡部组3例和间隔峡部组2例在首选消融方法失败后，改用另一种消融方法获得成功。两组患者的放电次数和手术时间均无显著性差异。平均随访12.4±6.8个月，在后位峡部消融成功者中，有2例房扑复发。结论：射频消融右房后位峡部和间隔峡部治疗房扑均安全有效，两种方法互补可以提高消融的成功率。
中图分类号 R541.7+ 5 文献标识码 A
文章编号 1007—2659(2000)02—0101—03
Radiofrequency Catheter Ablation of Typical Atrial Flutter:To Compare the Effects of Posterior Isthmus Ablation Method and Septal Isthmus Ablation Method.
MA Jian,CHU Jian-min,WANG Fang-zheng,et al.
The purpose of this study is to compare the effects of radiofrequency ablation posterior isthmus and septal isthmus for typical atrial flutter.Forty-one patients with typical atial flutter were randomly assigned to undergo radiofrequency catheter ablation with the posterior isthmus ablation line (PI group,eighteen patients) or sepal isthmus ablation line (SI group,twenty-three patients).Radiofrequency energy was used to create linear lesion from tricuspid ring to inferior vena cava in PI group and from tricuspid ring to Eustachian ridge in SI group,respectively.The endpoint of successful ablation included inability to induce atrial flutter and complete bidirectional conduction block at isthmus.The endpoint was achieved in forty patients (97.6%) without any complication.The ablation line had to change for three patients in PI group and two patients in SI group after the primary ablation line was unsuccessful.The numbers of radiofrequency application and procedure time were not significantly different in both groups.During a mean follow-up of 12.4±6.8 months,two patients (PI group) experienced atrial flutter recurrence.Radiofrequency ablation of the typical atrial flutter was safe and effective with either the poterior isthmus ablation technique or the septal isthmus abaltion technique.The ablation success rate can be incresed when these two ablation methods are used supplementally with each other.
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