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右侧壁是右侧房室旁道导管射频消融（ＲＦＣＡ）较困难区域。对６例ＲＦＣＡ失败和（或）复发的右侧壁房室旁道再次消融成功进行分析，以探讨其消融的方法学。选用８Ｆ加硬大头或温控导管，部分病例使用Ｓｗａｒｔｚ鞘辅助操作，均经静脉途径于三尖瓣环上进行消融。６例患者术中均成功阻断旁道，有效放电１１次、射频电流功率平均４３±６（３０～５０）Ｗ、放电时间平均３７９±８１（２７０～４８０）ｓ，与５０例右侧其它部位旁道消融功率（平均３６±４Ｗ）和时间（平均２４０±２３ｓ）分别相比，Ｐ均＜０．０５。５例患者随访期间停用抗心律失常药物，无心动过速发作；１例术后１６ｈ再次复发。体会：采用高功率、长时间放电可取得一定疗效；常规选用加硬导管，部分使用温控导管，辅以适当的Ｓｗａｒｔｚ鞘管和提高导管操作技巧等有助于提高右侧壁旁道ＲＦＣＡ的成功率。
The right side wall is the more difficult area for radiofrequency catheter ablation (RFCA) of the right atrium. Six patients with RFCA failure and / or recurrence were retrospectively analyzed for successful ablation of the right accessory atrioventricular canal in order to investigate its methodology for ablation. Choose 8F hard head or temperature control catheter, in some cases the use of Swartz sheath assisted operation, are intravenous approach in the tricuspid annulus for ablation. Six patients were successful in blocking the bypass during surgery, the effective discharge of 11 times, RF current power average 43 ± 6 (30 ~ 50) W, discharge time average 379 ± 81 (270 ~ 480) s, and 50 cases of other right There was no significant difference between the two groups (P <0.05) .Patients with bypass radiofrequency ablation (mean 36 ± 4W) and time (average 240 ± 23s) respectively, all had P <0.05.5 Patients with antiarrhythmic drug were discontinued during follow- Recurrence occurred again 16h after operation. Experience: the use of high-power, long-term discharge can be achieved certain effect; conventional use of stiff catheter, the use of temperature-controlled catheter in part, with appropriate Swartz sheath and improve the catheter handling skills to help improve the right side of the bypass RFCA Success rate.