Variable location of accessory pathways associated with the permanent form of junctional reciprocating tachycardia and confirmation with radiofrequency ablation.
Variable location of accessory pathways associated with the permanent form of junctional reciprocating tachycardia and confirmation with radiofrequency ablation.
复制标题
与永久性交界性往复性心动过速相关的旁路位置可变，并通过射频消融进行确认。
DOI：
10.1016/0002-9149(92)90457-a
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Walsh,EP
中科院分区：
文献类型：
--
作者：
Ticho,BS;Saul,JP;Hulse,JE;De,W;Lulu,J;Walsh,EP
永久性交界性往复性心动过速(PJRT)主要发生在年轻患者，导致几乎不间断的心动过速，这种心动过速往往对药物治疗无效。以往的非药物治疗包括手术或直流电导管消融希氏束或旁路。PJRT中的旁路被描述为具有逆行和顺行递减传导特性，通常位于后间隔位置。本文报道了8例PJRT患者的射频消融旁道。所有消融均成功，无不良反应。8例患者中有6例在心房激动前检测到旁道电位。一项新的发现是，根据消融成功的位置确定的8个径路位置中，有5个不在典型的后间隔区域。1例位于右后间隔，2例位于右心房游离壁，1例位于右前间隔，1例位于右后间隔，1例位于隔区外。结论：射频消融是治疗青年PJRT的一种安全有效的方法。由于旁道可以位于后间隔区域之外，因此仔细标测右和左房室沟可能是成功消融的必要条件。
Permanent Junctional reciprocating tachycardia (PJRT) occurs primarily in young patients and causes nearly incessant tachycardia that is frequently refractory to pharmacologic treatment. Previous nonpharmacologic therapy has included surgical or direct-current catheter ablation of either the His bundle or the accessory pathway. The accessory pathway in PJRT has been described as having retrograde and anterograde decremental conduction properties, and is typically identified in the posteroseptal location. This report describes radiofrequency catheter ablation of accessory pathways in 8 patients with PJRT. All ablations were successful and without adverse effects. Accessory pathway potentials were detected just before atrial activation in 6 of 8 patients. A new finding was that 5 of the 8 pathway locations, as identified by the site of successful ablation, were not in the typical posteroseptal region. In 1 patient it was located in the right posteroseptal region, 2 were in the right atrial freewall, 1 was in the right anterior septum and 1 was in the left posterior region just outside of the septal region. In conclusion, radiofrequency catheter ablation can be a highly effective and safe method for treatment of young patients with PJRT. Because the accessory pathways can be located outside of the posteroseptal region, careful mapping of both the right and left atrioventricular groove may be necessary for successful ablation.