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探索经胸心脏超声引导心内射频消融房室结的可行性和安全性。对11例持续/永久性心房颤动/心房扑动拟行房室结消融加VVI起搏,在经胸心脏彩超引导下,采取多切面观察、导管运动中观察,密切结合心内电生理定位,尝试左锁骨下静脉永久起搏导管和右股静脉消融导管的心内定位和靶点消融。以出现稳定的房室分离判为消融成功。结果:11例房室结消融及VVI起搏均顺利完成,手术时间70～180min,放电期间超声切面可见能量释放征,消融后靶点区心内膜回声明显增强。手术成功率100%,随访期内患者恢复良好。结论:经胸切面超声引导射频消融房室结安置VVI起搏安全、简便、可行、经济。
To explore the feasibility and safety of transthoracic echocardiography for atrioventricular node radiofrequency ablation. 11 cases of persistent / permanent atrial fibrillation / atrial flutter to be atrioventricular node ablation plus VVI pacing, under the guidance of transthoracic echocardiography, multi-slice observation, catheter movement observed in close connection with electrophysiological localization, Attempting to locate the intracardiac and target ablation of the left subclavian permanent pacing catheter and the right femoral vein ablation catheter. In order to appear stable separation of atrioventricular node is successful. Results: 11 cases of atrioventricular node ablation and VVI pacing were successfully completed. The operation time was 70 ~ 180min. During the discharge, the energy release sign was observed on the ultrasound section, and the echo of the endocardial area in the target area after ablation was significantly enhanced. The success rate of surgery was 100%. The patients recovered well during the follow-up period. Conclusion: It is safe, simple, feasible and economical to guide the radiofrequency ablation of atrioventricular node in VVI pacing through transthoracic ultrasound.