Cryosurgical Ablation of the A‐V Node‐His Bundle: A New Method for Producing A‐V Block
Cryosurgical Ablation of the A‐V Node‐His Bundle: A New Method for Producing A‐V Block
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冷冻手术消融 A-V 结-His 束：一种生产 A-V 块的新方法
DOI：
10.1161/01.cir.55.3.463
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发表时间：
1977
期刊：
影响因子：
37.8
通讯作者：
A. Wallace
中科院分区：
文献类型：
--
作者：
L. Harrison;J. Gallagher;J. Kasell;R. Anderson;E. Mikat;D. Hackel;A. Wallace
使用冷冻手术器械消融房室传导。该程序在20只狗中进行，随后在3名患有耐药性、危及生命的室上性心动过速的患者中进行。在患者中，冷冻手术装置将希氏束区域的温度降低到0°C，实现完全但可逆的心脏传导阻滞。复温后恢复正常房室传导。然后将希氏束区域冷却至-60 °C;通过两次或更多次90-120秒的冷冻产生完全心脏传导阻滞。术后评估显示持续性房室传导阻滞。病变没有破裂、形成动脉瘤或干扰瓣膜功能的倾向。在临床病例中，术后研究表明，一个稳定的起搏器产生近端的分支部分的希氏束。冷冻外科技术的一个潜在应用可能是消融心律失常的部位（即，异位病灶、折返回路、旁路）。
A cryosurgical instrument was used to ablate atrioventricular conduction. The procedure was carried out in 20 dogs and subsequently in three patients with drug resistant, life-threatening supraventricular tachycardias. In patients, the cryosurgical unit lowered the temperature of the His bundle area to 0°C, effecting complete but reversible heart block. Rewarming resulted in resumption of normal atrioventricular conduction. The His bundle region then was cooled to −60°C; complete heart block was produced with two or more 90–120 second freezes. Postoperative evaluations revealed persistent atrioventricular conduction block. The lesion showed no tendency to rupture, form aneurysm, or interfere with valvular function. In the clinical cases, postoperative studies demonstrated a stable pacemaker arising proximal to the branching portion of the His bundle. A potential application of the cryosurgical technique might be ablation of sites of dysrhythmia (i.e., ectopic foci, re-entry circuits, accessory pathways).