摘要
目的探讨心脏结周消融治疗缓慢心律失常的可行性和安全性方法选择症状严重,拟行起搏器治疗的功能性心动过缓患者,在影像解剖和心内电图神经电位指引下行导管射频消融。结果 10例患者,男性8例,女性2例,1例有器质性心脏病,6例房室阻滞,4例窦房结功能障碍。在窦房结和房室结周围均记录到神经电位,放电10～15 s神经电位消失。消融中先出现迷走神经激惹效应,之后窦房结和房室结功能改善。9例术中心动过缓消失,1例失败。随访2～12个月,2例复发,余症状消失,无并发症。结论心脏结周消融治疗迷走介导的缓慢心律失常安全可行。
Objective To study the feasibility and safety of neuroablation surrounding the cardiac nodes in the treatment of vagal mediated bradyarrhythmias. Methods Electrophysiologic studies were performed in highly symptomatic patients with functional atrioventricular block and sick sinus syndrome. Neuroablation was conducted surrounding the atrioventricular node and sinus node, which was guided by neuro-potentials,with radiofrequency energy and conventional catheter. Results Ten patients underwent completed studies. There were eight men,two woman, with mean age of （40. 1 ± 6. 3 ） years old. One patient had structural heart disease. Six had atrioventricular block,four had sick sinus syndrome. Neuro-potential was recorded surrounding the cardiac nodes in all the patients, and disappeared in 10 - 15 s after the delivery of the radiofrequency energy. Vagal reaction was observed before the improvement of sinus node and atrioventricular node function. Ablation was successful in 9 patients and failed in one patient with persistent high-degree atrioventricular block. No complication occurred during the procedure. During a mean follow-up of （ 6. 5 ± 4. 1 ） months, seven patients remained asymptomatic ,three patients had the implantation of cardiac pacemaker. Conclusions It is safe and feasible to treat the vagal mediated bradyarrhythmia by neuroablation surrounding the cardiac nodes.
出处
《中华心律失常学杂志》
2007年第6期448-451,共4页
Chinese Journal of Cardiac Arrhythmias
关键词
射频导管消融
去神经消融
窦性心动过缓
房室阻滞
Radiofrequency catheter ablation
Denervation
Sinus bradycardia
Atrioventricular block
