右侧旁道并永存左上腔静脉畸形的射频消融7例

摘要

Objective To summarize radiofrequency cather ablation (RFCA)of tachycardias with right sid-ed accessory atrioventricular pathway in 7 patients with persistent left superior vena cava (PLSVC). Methods RF-CA for right sided accessory atrioventricular pathway in 7 patients with PLSVC was carried out . Coronary sinus ac-cess was performed through the left subclavian and the left femoral vein respectively. Swartz sheath was used during ablation if neccesary. Results There was no siginificant differences in fluoroscopy time between the left subclavian approach and the left femoral vein approach[(2.8 ± 0.6)min vs (3.2 ± 0.3)min, P>0.05)]. No recurrence of ac-cessory pathway conduction was found during a mean follow-up of (23 ± 11) months. The mean discharging time and fluoroscopy time were (312 ± 67)s and (17 ± 5)min respectively. Conclusions Although RFCA of right sided accessory atrioventricular pathway in patients with PLSVC shows specialities in cather manipulation , mapping and ablation, high successful results can be achieved by experienced physician.%目的：总结右侧旁道并永存左上腔静脉畸形的射频消融7例的方法及经验。方法：回顾分析2005年3月至2013年9月因阵发性室上性心动过速于我院心脏介入中心行经导管射频消融术的患者中7例右侧旁道并永存左上腔静脉畸形的病例资料，所有患者均行冠状静脉窦造影确诊，冠状静脉窦标测电极的放置中4例采用经左锁骨下静脉途径，3例采用经左股静脉途径，7例中5例采用SwartzRS0长鞘增加贴靠稳定性。结果：经左锁骨下静脉放置电极曝光时间为（2．8±0．6）min，经左股静脉途径曝光时间为（3．2±0．3）min（P＞0．05），7例患者均成功消融阻断旁道，平均放电时间（312±67）s，曝光时间（17±5）min。消融成功率100％，无并发症。术后随访（23±11）个月，无1例复发。结论：右侧旁道并永存左上腔静脉畸形在电极放置、标测与消融的方法上有其特殊性，但仍可获得较高的成功率。