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中国心血管杂志 2003年第4期8卷 267-269页

作者：王业松马虹唐安丽廖新学柳俊何建桂吴素华中山大学附属第一医院心内科广东广州510080

目的　探讨右心房房性心动过速的导管标测和消融方法。方法　常规电生理检查确诊 12例右心房房性心动过速后 ,2 0极标测导管在右心房内弯曲、旋转粗标右心房的不同面 ,寻找较体表心电图 P波提前的相对较早的心房内心电图 ,以此心电图的... 详细信息

目的　探讨右心房房性心动过速的导管标测和消融方法。方法　常规电生理检查确诊 12例右心房房性心动过速后 ,2 0极标测导管在右心房内弯曲、旋转粗标右心房的不同面 ,寻找较体表心电图 P波提前的相对较早的心房内心电图 ,以此心电图的电极对作为参考点 ,消融导管通过 Swartz鞘在该点附近仔细标测 ,寻找最早心房激动点消融。射频消融的能量从 15 W开始逐渐递增至 2 5 W。结果　 12例右心房房性心动过速均消融成功 ,无并发症 ,随访 (2 6± 14 )月未见复发。成功消融部位在冠状窦口附近 5例 ,希氏束附近 2例 ,房间隔中部 3例 ,右心房高侧壁 2例。消融成功部位的心房内心电图较 P波提前 (42± 12 ) m s。终止房性心动过速初始放电能量均为 15 W,时间均在5 s内。放电次数 2～ 6次。X线曝光时间 (38± 16 ) min。结论　多极标测导管粗标 ,消融导管经

关键词：心房心动过速/治疗导管消融术/方法

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内皮抑素联合微波消融治疗裸鼠肾癌移植瘤研究

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实用肿瘤杂志 2010年第6期25卷 631-633页

作者：王金清赵玉斌梁永强诸城市人民医院山东诸城262200

目的研究内皮抑素联合微波消融对裸鼠肾癌移植瘤的抑制作用。方法将人源性肾癌细胞接种到48只小鼠的背部皮下,肿瘤直径约1.5 cm时随机分成4组,对照组:隔日尾静脉生理盐水;联合治疗组:隔日尾静脉推注内皮抑素+皮下肿瘤微波消融;微波消融... 详细信息

目的研究内皮抑素联合微波消融对裸鼠肾癌移植瘤的抑制作用。方法将人源性肾癌细胞接种到48只小鼠的背部皮下,肿瘤直径约1.5 cm时随机分成4组,对照组:隔日尾静脉生理盐水;联合治疗组:隔日尾静脉推注内皮抑素+皮下肿瘤微波消融;微波消融组:皮下肿瘤微波消融;内皮抑素组:隔日尾静脉推注内皮抑素。首先对联合治疗组及微波消融组局部皮下肾移植瘤进行微波消融治疗,其后经尾静脉注射药物。14天后每组处死6只小鼠,比较各组瘤重,计算抑瘤率,检测血浆VEGF浓度,剩余6只小鼠观察其存活期。结果联合治疗组小鼠肿瘤体积显著小于其他各组(P<0.0 5),其血浆VEGF水平较其他各组显著减低(P<0.0 5),存活时间较其他各组显著延长(P<0.05)。结论内皮抑素联合微波消融抗肿瘤作用优于单用内皮抑素或微波消融治疗,并使小鼠存活期延长。

关键词：肾肿瘤/治疗内皮抑素类/治疗应用微波/治疗应用导管消融术/方法肿瘤移植血管内皮生长因子A 疾病模型,动物

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ULTRASOUND ANGIOPLASTY - A REVIEW

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JOURNAL OF INTERVENTIONAL CARDIOLOGY 1993年第1期6卷 77-94页

作者： STEFFEN, W SIEGEL, RJ CEDARS SINAI MED CTR DEPT MEDDIV CARDIOL8700 BEVERLY BLVDRM 5314LOS ANGELESCA 90048

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COMPARISON OF CATHETER ABLATION USING DIRECT-CURRENT ENERGY VERSUS RADIOFREQUENCY - OBSERVATIONS IN 147 PATIENTS WITH SUPRAVENTRICULAR TACHYARRHYTHMIAS

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JOURNAL OF INTERVENTIONAL CARDIOLOGY 1993年第2期6卷 137-147页

作者： TRAPPE, HJ KLEIN, H WENZLAFF, P HUANG, J LICHTLEN, PR DepartmentofCardiology UniversityHospitalHannoverGermany.

We studied the follow-up of 147 patients who underwent catheter ablation because of drug resistant supraventricular tachyarrhythmias. Direct current (DC) ablation was performed in 116 patients, while 31 patients underwent radiofrequency (RF) ablation. In 101 patients (87%) with DC ablation and in 28 patients (90%) with RF ablation, complete atrioventricular (AV) block was achieved initially. Fifteen patients (13%) with DC ablation and three patients (11%) with RF ablation resumed AV conduction. Serious complications occurred in eight patients (7%) with DC ablation and in none of the patients with RF ablation. During the mean follow-up of 45 +/- 24 months, 13 patients died (11%) who underwent DC ablation;during the mean follow-up of 11 +/- 3 months, no patient died who had had RF ablation. Transcatheter ablation using DC or RF is an effective treatment in patients with drug resistant supraventricular arrhythmias, providing a beneficial long-term outcome including an improved quality of life. Although the risk of complications is low, this procedure should be reserved for patients with supraventricular arrhythmias who do not respond to conventional drug therapy.

关键词：成年人老年人导管消融术/仪器和设备导管消融术/方法抗药性评价研究女(雌)性随访研究人类男(雄)性中年人手术后并发症存活率心动过速室上性/死亡率心动过速室上性/外科学治疗结果

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Randomized comparison of two targets in typical atrial flutter ablation

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AMERICAN JOURNAL OF CARDIOLOGY 2000年第11期85卷 1302-1307页

作者： Anselme, F Klug, D Scanu, P Poty, H Lacroix, D Kacet, S Cribier, A Saoudi, N Hop Charles Nicolle Dept Cardiol F-76031 Rouen France Lille Univ Hosp Lille France Caen Univ Hosp Caen France

Typical atrial flutter ablation has become anatomically guided to 2 separate sites within the isthmus at the inferior right atrium: (1) between the inferior vena cava and the tricuspid annulus (anterior side of the isthmus [A]), (2) between the eustachian crest, the coronary sinus ostium and tricuspid annulus (posterior side of the isthmus [P]). We prospectively compared ablation results at these sites in 72 consecutive patients. Patients were randomized in group P or A according to the initial target site. If ablation failed at 1 site after 15 radiofrequency (RF) pulses, the other side of the isthmus was targeted. Before 15 RF pulses, complete bidirectional isthmus block was achieved in 30 of 36 group A patients and in 25 of 36 group P patients, with similar mean RF pulses number, procedure time, and fluoroscopy time. After shifting to the other target, success was finally obtained at P in 2 of 6 group A patients, and at A in 8 of 11 group P patients before a maximum of 30 RF pulses. Among successful patients, number of RF pulses, procedure time, and fluoroscopy time were significantly lower in group A (7.2 +/- 5.4 vs 11.0 +/- 8.1 pulses, p = 0.03;131 +/- 44 vs 163 +/- 66 minutes, p = 0.03;31 +/- 19 vs 46 +/- 24 minutes, p = 0.01, respectively). Impairment of artioventricular (AV) nodal conduction occurred in 5 patients only during ablation at P. AV block was transient in 4 patients and permanent in 1. Although atrial flutter ablation is equally effective at P and A, success seems easier to obtain when A is first targeted. Ablation at P is associated with a significant risk of AV block. (C) 2000 by Excerpta Medica, Inc.

关键词：心房扑动/诊断心房扑动/外科学导管消融术/方法心电描记术心房/外科学心脏传导阻滞/病因学手术后并发症/病因学前瞻性研究复发再手术治疗结果成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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EARLY AND LONG-TERM RESULTS OF CATHETER ABLATION IN PATIENTS WITH INCESSANT VENTRICULAR-TACHYCARDIA

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JOURNAL OF INTERVENTIONAL CARDIOLOGY 1992年第3期5卷 163-170页

作者： TRAPPE, HJ KLEIN, H WENZLAFF, P LICHTLEN, PR Department of Cardiology University Hospital Hannover Germany.

Catheter ablation of sustained monomorphic ventricular tachycardia (VT) with high energy DC shock (360-400 J) was performed in 11 patients with incessant VT (duration > 24 hours), refractory to antiarrhythmic drugs, and DC cardioversion. There were ten patients with coronary disease and one patient had dilated cardiomyopathy. Direct current energy was delivered at the earliest endocardial activation in six patients (group I) or at the area of slow conduction in five patients (group II). Incessant VT was terminated by DC ablation in nine patients (82%). After the ablation procedure VT remained inducible in four patients in group I (67%) and in one patient (20%) in group II. Two patients in group II had to go to emergent surgery. During the mean follow-up of 31 +/- 26 (1-66) months nonfatal VT recurrences occurred in five patients in group I and in one patient in group II.

关键词：心肌病扩张型/并发症导管消融术/方法冠心病/并发症电生理学随访研究心脏停搏/病因学复发心动过速室性/病因学心动过速室性/外科学成年人老年人人类男(雄)性中年人

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Cavaterm thermal balloon ablation for the treatment of menorrhagia

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BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1999年第11期106卷 1143-1148页

作者： Hawe, JA Phillips, AG Chien, PFW Erian, J Garry, R S Cleveland Hosp WEL Fdn Middlesbrough TS4 3BW Cleveland England Univ Dundee Ninewells Hosp Dept Obstet & Gynaecol Dundee Scotland Farnborough Hosp Orpington Kent England

Fifty patients due to undergo endometrial ablation as a treatment of dysfunctional uterine bleeding were recruited to assess the efficacy and safety of a new thermal balloon ablation system (Cavaterm). The patients were followed up for a mean of 14 months (range 6-24): 34 (68%) have complete amenorrhoea, 12 (24%) only have spotting, two (4%) are eumenorrhoeic, and two (4%) have had failed treatments. There were no major complications, but two patients have required oral antibiotics for suspected endometritis. Although these preliminary results are encouraging, all patients remain under review to determine long term effect of the procedure. Further evaluation is also underway in the form of a randomised trial against endometrial laser ablation.

关键词：导管消融术/仪器和设备导管消融术/方法导管插入术/仪器和设备导管插入术/方法子宫内膜高温诱发/方法月经过多/治疗试点项目存活率分析治疗结果女(雌)性人类中年人

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Catheter ablation of left accessory atrioventricular connections: The transseptal approach

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JOURNAL OF INTERVENTIONAL CARDIOLOGY 1995年第6期8卷 806-812页

作者： Montenero, AS Crea, F Bendini, MG Bellocci, F Zecchi, P CardiologyInstitute CatholicUniversityRomeItaly.

Background: In the past few years, there has been a relative explosion of activity in the realm of interventional cardiology. The high rate of success of radiofrequency energy ablation have transformed catheter ablation from an investigational procedure into the first-line therapy for symptomatic Wolff-Parkinson-White syndrome. Radiofrequency catheter ablation for preexcitation syndrome is commonly based on a ventricular approach. Such an approach might be associated with the risk of prolonged arterial catheter manipulation, retrograde left ventricular catheterization, and production of multiple, potentially arrhythmogenic, ventricular lesions created during ablation. Potential risks can be avoided using atrial insertion ablation procedures. The transseptal procedure that was developed in the 1950s and 1960s as a diagnostic procedure and then shelved in the 1970s and early 1980s has now come back into prominence as a therapeutic technique in the treatment of valvular heart disease, and then in the ablation of the left accessory atrioventricular connections. Methods: Atrial aspect of mitral annulus is a relatively smooth, nonobstructed surface that simplifies catheter movement, thereby permitting rapid and accurate accessory pathway location. Although primary rise of earliest endocardial retrograde atrial activation as a marker of accessory pathway atrial insertion is sufficiently accurate to permit successful ablation, direct recording of an accessory pathway potential is an important predictor of successful ablation site. Moreover, the analysis of the unipolar atrial electrogram, recorded during sinus rhythm front the tip of the ablation catheter-, provides further information for localizing the atrial insertion of the accessory pathways. Shortest atrial-accessory pathway and negative delta-accessory pathway intervals have been found to be the best predictors of the successful site. Results: A 90.5% success of the transseptal approach on an overall population of 32

关键词：导管消融术/方法心电描记术心间隔/外科学 Wolff-Parkinson-White综合征/病理生理学 Wolff-Parkinson-White综合征/外科学人类

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THE USE OF RADIOFREQUENCY ENERGY IN PEDIATRIC CARDIOLOGY

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JOURNAL OF INTERVENTIONAL CARDIOLOGY 1995年第5期8卷 557-568页

作者： DOROSTKAR, PC DICK, M 1 Division of Pediatric Cardiology University of California San Francisco San Francisco California2 Department of Pediatrics University of Michigan Ann Arbor Michigan

The use of radiofrequency energy for the treatment of supraventricular tachycardia in pediatric patients has gained widespread acceptance, especially for tachyarrhythmias associated with palpitations, dizziness, presyncope or syncope, cardiomyopathy, and cardiac arrest. Ablation of the substrate supporting atrioventricular reentry, atrioventricular node reentry, and automatic atrial tachycardia yields a 90%-98% success rate with low incidence (<1%) of complications and adverse side-effects. Ablation of intra-atrial reentry, including atrial flutter and fibrillation, appears to be promising and would be a significant advance in the management of patients following extensive atrial surgery for congenital heart disease. Radiofrequency energy is also used to treat various forms of idiopathic ventricular tachycardia. Finally, radiofrequency energy has been extended to control the ventricular rate associated with malignant atrial tachycardia by either modification or ablation of the atrioventricular node, and subsequent pacemaker implant. Long-term outcome of radiofrequency ablation is unknown, but the short-to-intermediate (1-5 yrs) outcome is excellent, with low recurrence rate of the tachycardia, no proarrhythmic effect, and excellent clinical state.

关键词：导管消融术/方法超声心动描记术经食管心动过速室上性/外科学心动过速室上性/超声检查儿童人类

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CATHETER ABLATION IN SUPRAVENTRICULAR TACHYARRHYTHMIAS

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JOURNAL OF INTERVENTIONAL CARDIOLOGY 1995年第1期8卷 59-67页

作者： DESHPANDE, S JAZAYERI, M DHALA, A BLANCK, Z SRA, J AKHTAR, M WisconsinElectrophysiologyGroup UniversityofWisconsinMilwaukeeHeartInstituteofSinaiSamaritanMedicalCenter53233USA.

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