Halo导管在射频消融右侧房室旁路中的应用

目的　总结 8例射频消融失败或复发的右侧游离壁房室旁路病例 ,应用 Halo导管再次消融成功的经验。　方法　 8例患者 ,2例为复发病例 ,6例为失败病例。电生理检查时根据 Halo导管电极 (环绕在三尖瓣环的心房侧 )在窦性心律和心室 S1 S1 刺激时记录的心内电图初步判定旁路位置 ,然后用大头电极标测消融。　结果　共 9条旁路 (双旁路 1例 ,单旁路 7例 )全部消融成功。Halo导管电极记录最早 V波者 2例 ,最早 A波者 6例 ,大头电极在 H alo导管电极提示最早 A波的电极对的部位均可记录到与之提前度相同或更为提前的成功靶点图。手术时间及 X线曝光时间与对照组比较差异不显著。　结论　在右侧旁路的复发和失败病例的消融过程中 ,放置 H alo导管 ,能够提高成功率 ,减少复发 ,节省标测时间。

Successful experience on ablation of right lateral atrioventricular accessory pathway by radiofrequency current with aid of Halo catheter

Objective To summarize the successful experience on ablation of right lateral atrioventricular accessory pathway (AP) by radiofrequency current with aid of Halo catheter. Methods Eight patients including 2 recurrent and 6 unsuccessful cases were treated.In electrophysiologic study,Halo catheter was placed around the tricuspid annulus to roughly judge the location of AP according to intracardiac electrogram recorded from it,the target site was accurately mapped with the large tip catheter. Results Nine right lateral atrioventricular AP in eight cases were successfully ablated.The earliest V wave could be recorded in 2 cases with Halo catheter,while the earliest A wave could be recorded in 6 cases.Near the site of the earliest V or A wave at the Halo catheter,large tip catheter could locate the acurrate target site of AP.The time of ablating procedure and X ray exposure was quite similar to those without using a Halo catheter. Conclusion With aid of Halo catheter,the successful rate of ablating right lateral atrioventricular AP was improved,and the recurrent rate and mapping time were reduced.