Transcatheter Ablation of Ectopic Atrial Tachycardia in Young Patients Using Radiofrequency Current
Transcatheter Ablation of Ectopic Atrial Tachycardia in Young Patients Using Radiofrequency Current
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使用射频电流经导管消融年轻患者异位房性心动过速
DOI：
10.1161/01.cir.86.4.1138
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发表时间：
1992
期刊：
影响因子：
37.8
通讯作者：
J. Lock
中科院分区：
文献类型：
--
作者：
E. Walsh;J. Saul;J. Hulse;L. Rhodes;A. Hordof;J. Mayer;J. Lock
背景异位房性心动过速（EAT）是心肌病的可逆性原因，但通过常规治疗可能很难控制。经导管射频消融作为药物或手术治疗的替代方案进行了测试。 方法和结果 12 名患有耐药性 EAT 的年轻患者（年龄 10 个月至 19 岁）接受了使用射频 (RF) 能量直接经导管异位病灶消融的治疗。根据超声心动图标准，所有患者的左心室收缩力均降低，缩短分数为 10-26%（中位数为 20%；正常为 28-35%）。七例中 EAT 被映射到左心房，五例中 EAT 被映射到右心房。异位部位的局部心房激动早于表面 P 波的出现 20-60 毫秒（中位时间 42 毫秒）。射频应用成功后，心动过速在 0.5–13.0 秒（中位数为 2.0 秒）内终止。消融有效地消除了 12 名患者中的 11 名 (92%) 的 EAT，所有患者在中位住院时间 48 小时后均以窦性心律出院，无需药物治疗。一名右心房前部弥漫性发育不良的患者消融不成功，但在手术切除异常心房组织后，该患者最终恢复良好。一名患者成功消融了靠近窦房结的 EAT 病灶，但在 72 小时内恢复了正常的窦房结功能，但患者注意到窦房结功能出现暂时性抑制。没有遇到其他并发症。在随访期间（3-21 个月；中位时间 13 个月），一名患者出现缓慢且持续性较差的 EAT 复发，并在第二次消融治疗中成功消除。所有其他人均保持窦性心律，所有 12 名受试者均恢复正常心室功能。结论射频消融似乎是耐药性异位房性心动过速的安全有效的治疗选择，并且可能是心室功能低下患者的首选一线治疗方法。
BackgroundEctopic atrial tachycardia (EAT) is a reversible cause of cardiomyopathy but may be quite difficult to control with conventional therapy. Transcatheter ablation with radiofrequency current was tested as an alternative to medical or surgical treatment of this condition Methods and ResultsTwelve young patients (aged 10 months to 19 years) with drug-resistant EAT were treated with direct transcatheter ablation of the ectopic focus using radiofrequency (RF) energy. All had depressed left ventricular contractility by echocardiographic criteria, involving shortening fractions of 10–26% (median, 20%; normal, 28–35%). The EAT was mapped to the left atrium in seven cases and to the right atrium in five. Local atrial activation at the ectopic site preceded the onset of the surface P wave by 20–60 msec (median, 42 msec). Tachycardia terminated 0.5–13.0 seconds (median, 2.0 seconds) into a successful RF application. The ablation effectively eliminated EAT in 11 of 12 patients (92%), all of whom were discharged in sinus rhythm without medications after a median hospital stay of 48 hours. Ablation was unsuccessful in one patient with diffuse dysplasia of the anterior right atrium, who eventually did well after surgical resection of abnormal atrial tissue. Transient depression of sinus node function was noted in one patient who had successful ablation of an EAT focus in close proximity to the sinus node, although normal sinus node function returned within 72 hours. No other complications were encountered. During follow-up (3–21 months; median, 13 months), one patient had recurrence of a slower and less-sustained EAT that was successfully eliminated at a second ablation session. All others remained in sinus rhythm, and all 12 subjects recovered normal ventricular function ConclusionsRF ablation appears to be a safe and effective therapeutic option for drug-resistant ectopic atrial tachycardia and may be the preferred first-line therapy for those patients with depressed ventricular function.
成人右心房局灶性心动过速的手术治疗。
影响因子：
24
作者：
Seals,AA;Lawrie,GM;Magro,S;Lin,HT;Pacifico,A;Roberts,R;Wyndham,CR
通讯作者：
Wyndham,CR
影响因子：
158.5
作者：
JACKMAN, WM;WANG, XZ;LAZZARA, R
通讯作者：
LAZZARA, R
影响因子：
37.8
作者：
Langberg,JJ;Chin,MC;Rosenqvist,M;Cockrell,J;Dullet,N;VanHare,G;Griffin,JC;Scheinman,MM
通讯作者：
Scheinman,MM