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目的:探讨永存左上腔静脉(PLSVC)并发室上性心动过速(SVT)的射频消融策略。方法:2008年6月～2011年6月在我科行射频消融的SVT患者1 460例,17例并发PLSVC。其中房室结折返性心动过速(AVNRT)8例,左侧隐匿性旁路伴房室折返性心动过速(AVRT)6例,阵发性房颤(PAF)3例。结果:17例患者均经左锁骨下静脉穿刺成功,并放置冠状窦电极,8例AVNRT患者经房室结改良成功;6例左侧隐匿性旁路,4例经主动脉逆行途径消融,2例经房间隔穿刺,在二尖瓣心房侧进行旁路消融;3例PAF患者行房间隔穿刺后行环肺静脉电隔离。消融成功率100%,无手术并发症。结论:PLSVC并发SVT,导管消融治疗仍有较高的手术成功率和较低的手术并发症,但在左锁骨下静脉穿刺的识别、导管消融的技巧及手术并发症的防治方面仍有其特殊性。
Objective: To investigate the radiofrequency ablation strategy of perpetuating left superior superior vena cava (PLSVC) complicated with supraventricular tachycardia (SVT). Methods: From June 2008 to June 2011, 1460 SVT patients undergoing radiofrequency ablation in our department were included, and 17 cases were complicated with PLSVC. There were 8 cases of atrioventricular nodal reentrant tachycardia (AVNRT), 6 cases of occult bypass left atrioventricular reentrant tachycardia (AVRT) and 3 cases of paroxysmal atrial fibrillation (PAF). Results: Seventeen patients were successfully punctured through the left subclavian vein and the coronary sinus electrodes were placed. Eight patients with AVNRT were successfully ameliorated by atrioventricular node. Six left occluded bypass, four ablated by aortic retrograde approach, two Cases of percutaneous atrial septal puncture in the mitral valve atrial bypass bypass; 3 cases of PAF after atrial septal puncture after the pulmonary vein electrical isolation. Ablation success rate of 100%, no surgical complications. CONCLUSIONS: PLSVC with SVT and catheter ablation still have a higher success rate of surgery and lower surgical complications. However, there are still some special characteristics in the diagnosis of left subclavian vein puncture, catheter ablation techniques and surgical complications Sex.