【摘要】 【目的】评价Swartz鞘在房室旁路标测和消融中的作用。【方法】 2 3例常规导管标测和消融未成功的房室旁路 ,采用消融导管经Swartz鞘标测和消融的方法。【结果】 2 3条旁路全部消融成功。 11条右外侧显性旁路用SR2 型和SR3 型Swartz鞘、12条左前外侧旁路 (显性 10条、隐匿性 2条 )用SL1和SL2 型Swartz鞘。标测和消融的操作时间 (4 6± 2 0 )min ,X线曝光时间 (2 4± 12 )min。右外侧和左前外侧显性旁路成功消融靶点图的比较 :A/V比值为 0 6 2± 0 32比 0 6 5± 0 2 8(P >0 0 5 )、AV间期为 (2 9± 12 )ms比 (37± 11)ms(P <0 0 5 )、VΔ间期为 (18± 11)ms比 (8± 9)ms(P <0 0 5 )、靶点图的稳定性为 0 74±0 16比 0 78± 0 12 (P >0 0 5 )。随访 (16± 14)月 ,无 1例复发。【结论】Swartz鞘有助于消融导管标测定位和消融导管头端电极与房室环紧密接触 ,从而提高消融成功率 ,减少复发 ,缩短操作时间。更多还原

【Abstract】 Objective To evaluate the effect of Swartz sheath on mapping and ablation of atrioventricular accessory pathway(AP). Methods 23 cases of atrioventricular AP failed by conventional catheter mapping and ablation techniques. They were mapped and ablated by catheter inserted through Swartz sheath. Results 23 atrioventricular AP in the 23 cases were successfully ablated. SR 2-3 Swartz sheaths were utilized in 11 right lateral overt AP. SL 1-2 Swartz sheaths were utilized in 12 left anterolateral AP (10 overt AP and 2 concealed AP). The mean procedure time of mapping and ablation was (46±20) min and the mean fluoroscopy time was (24±12) min. The right lateral overt AP were compared with the left overt AP in local endocardial electrograms recorded at successful ablation sites, which showed that A/V ratio was 0.62±0.32 vs 0.65±0.28(P>0.05), AV interval was (29±12) ms vs (37±11) ms(P<0.05), V-dalta interval was (18±11) ms vs (8±9) ms(P<0.05), and stability of atrial and ventricular electrograms was 0.74±0.16 vs 0.78±0.12(P>0.05). During a mean follow-up of (16±14) months,there is no recurrent case. Conclusion Swartz sheath not only contributes to catheter mapping and AP localization but also close contact of catheter tip electrode with the ring of atrioventricular valve. So the successful rate of ablation was improved,and the recurrent rate and procedure time were reduced.更多还原