Potential ablation of accessory atrioventricular pathways: injection of alcohol into the atrioventricular groove.
Potential ablation of accessory atrioventricular pathways: injection of alcohol into the atrioventricular groove.
复制标题
旁路房室通路的潜在消融：向房室沟注射酒精。
DOI：
10.1016/0003-4975(94)90397-2
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Cox,JL
中科院分区：
文献类型：
--
作者：
Creswell,LL;Rosenbloom,M;Pirolo,JS;Saffitz,JE;Cox,JL
副房室（AV）通路负责沃尔夫-帕金森-怀特综合征已成功地治疗手术和射频导管消融技术。在这项研究中，我们探索了通过直接注射100%乙醇到犬房室沟永久化学消融辅助通路的可行性。在5只成年杂种犬（第一部分）右冠状动脉槽内注射生理盐水（10 ~ 15ml），测量右冠状动脉血流量和房室压。房室沟室压从1±1增加到31±12 mm Hg (p<0.0001)，右冠状动脉血流从117±17增加到138±44 mL/min （p=无统计学意义）。在另外8只狗（第二部分）中，100%乙醇（10 mL）注射到左房室沟中。6周（n = 6）或12周（n = 2）后，左侧房室沟的组织学检查显示损伤的心外膜肌局部纤维置换，仅少量炎症浸润。旋动脉及其较大分支有轻度的内膜纤维化和内膜增生，但未见明显的管腔狭窄。12周（n = 2）的血管造影显示没有明显的旋动脉狭窄。综上所述，向房室沟注射100%乙醇能够局部消融心肌组织，可能包括传导组织，同时保留冠状动脉。
Accessory atrioventricular (AV) pathways responsible for the Wolff-Parkinson-White syndrome have been treated successfully by surgical and radiofrequency catheter ablation techniques. In this study, we explored the feasibility of permanent chemical ablation of accessary pathways by direct injection of 100% ethanol into the canine AV groove. Right coronary artery blood flow and AV compartment pressure were measured in 5 adult mongrel dogs (part I) during injection of saline solution (10 to 15 mL) into the right AV groove. Atrioventricular groove compartment pressure increased from 1 ± 1 to 31 ± 12 mm Hg (p<0.0001) and right coronary artery blood flow increased slightly from 117 ± 17 to 138 ± 44 mL/min (p= not significant). In 8 additional dogs (part II), 100% ethanol (10 mL) was injected into the left AV groove. After 6 weeks (n = 6) or 12 weeks (n = 2), histologic examination of the left AV groove demonstrated localized fibrous replacement of injured epicardial muscle, with only scant inflammatory infiltrate. Mild intimal fibrosis and intimal proliferation were present in the circumflex artery and its larger branches, but no significant luminal narrowing was evident. Angiograms at 12 weeks (n = 2) demonstrated no significant narrowing of the circumflex artery. In summary, injection of 100% ethanol into the AV groove is capable of locally ablating myocardial tissue, presumably including conductive tissues, while sparing the coronary arteries.