Usefulness of catheter ablation for atrial fivrillation

我们尝试在心房形成类似迷宫手术的线性损伤，用导管消融术恢复慢性心房颤动的窦性心律。将电极从颈静脉插入心房，并在颈部植入高频起搏器，以诱发持续性房颤。持续5s间隔刺激2-4周，造成持续性房颤犬。使用7 F四极Amazr导管（7 mm线圈，电极之间的距离为1.25 mm）在60度热控制下输送射频能量60秒，作为消融导管。由Medtronic公司制造的Atacker被用作高频发生器。分别对右心房和左心房进行线性消融. Amazr导管消融病灶，消融病灶在电极双端较宽，侵入深度加深，消融病灶随电极中心逐渐缩小.导管 ...更多信息 采用逐点消融法，逐渐移动导管，形成线状损伤。虽然在实验初期尝试了上级腔静脉-下腔静脉、下腔静脉-三尖瓣、房间隔-右房游离壁-三尖瓣的线性毁损，但消融后均诱发房颤。因此，右心房侧的线性损伤判断其对高频刺激诱发的持续性房颤不是很有效。然后，进行消融，其中左心房肺静脉周围和肺静脉周围区域被隔离。但消融后仍诱发房颤。心内膜侧无血栓形成，也识别出了透壁病变的位置，并确认了安全性。然而，很难线性地使电传导中断所需的透壁损伤，并且也认识到了正常情况下内膜侧保留的位置。讨论心外膜侧在心跳下可能无法获得足够的损伤，即使是以线性损伤准备为目的的导管。导管消融的迷宫手术似乎很困难。少

We tried to form linear lesion at atrium like MAZE operation using catheter ablation to restore sinus rhythm from chronic atrial fibrillation experimentally. The electrode was fixed from the jugular vein in atrium by insertion, and the high-frequent pacemaker was implanted in the cervix in order to induce persistent atria fibrillation. Keeping interval stimulation of the 5 seconds for the 2-4 week made the persistent atrial fibrillation dog. RF energy was delivered for 60 seconds using the Amazr catheter of 7F, quadrupoles (7mm coil, 1.25mm distance between electrodes) in the thermal control of 60 degrees as a catheter for the ablation. Atacker made by Medtronic Co. was used as a high frequency generator. The linear ablation was performed to the right atrium and left atrium side.1. Ablation lesion by the Amazr catheter.The ablation lesion was wide in the double end of the electrode, and the invasion depth deepened, and the ablation lesion was reduced with the electrode center.2. Cathet … More er ablation for atrial fibrillation.The linear lesion was made by the point-by-point method in which the catheter gradually moved. Though the linear lesion of superior vena cava-inferior vena cava, inferior vena cava-tricuspid valve, atrial septum-right atrium free wall-tricuspid valve was tried in the experiment initial stage, the atrial fibrillation was induced after the ablation. Therefore, the linear lesion in the right atrium side judged that it was not very effective in persistent atrial fibrillation induced by the high-frequent stimulation. Then, the ablation in which left atrial pulmonary vein circumference and region surrounded in the pulmonary vein were isolated was performed. However, the atrium fibrillation was still induced after the ablation. There was no thrombogenesis in the endocardium side and the position where the transmural lesion was obtained was also recognized, and the safety was confirmed. However, it was difficult to linearly make the transmural lesion necessary for the disruption of the electrical conduction, and the position where the endocardium side normally remained was also recognized.3. DiscussionThe sufficient lesion might not be obtained under the heartbeat from the epicardium side, even if it is a catheter made with the linear lesion preparation purpose. The MAZE operation by catheter ablation seemed to be difficult. Less