【摘要】 观察入心静脉口环状超声消融对心电传导及影像学的影响 ,探讨超声消融在治疗局灶源性心房颤动 (简称房颤 )中的临床价值。选用健康成年杂种犬 7只 ,用特制的超声球囊导管和温控大头导管在S1S1快速刺激下分别环状消融肺静脉口和上、下腔静脉口。超声消融时预设温度 60℃、功率 2 0W、脉宽 15ms,3 0 %输出方式 ;若放电 10s后温度达不到 5 0℃ ,则加大功率、脉宽或输出方式 ,直至达到有效消融温度 ( 5 5℃以上并持续 3 0s以上 ) ;观察消融前后心电传导的变化及管腔形态的变化。结果 :共超声消融入心静脉口 10个 ,除一个上腔静脉口因管腔直径过大只在放电时引起一过性电隔离外 ,其余 9个超声消融后都可造成持久的电隔离 ,且未见急性狭窄 ;而 7个射频消融的入心静脉口无一例形成持久的电隔离 ,且有 4例发生急性狭窄。结论 :超声消融更易在入心静脉口形成完全、持久的电隔离 ,很少导致管腔狭窄 ,且操作简单 ,安全可靠 ,优于射频消融。更多还原

【Abstract】 To evaluate the influence of catheter ablation by ultrasound on cardiac electrical transmission and the image and explore its clinical value in treatment of focally initiated atrial fibrillation,we select 7 healthy adult cannie for ablation the pulmonary vein orifice,superior and inferior vena cava and predetermine the temperature 60 ℃,the power 20 W,the pulse-width 15 ms and the output mode 30% at the ablation with ultrasound and observe the change of cardiac electrical transmission and the image before and after the ablation.Results:We found that it could get effective ablation temperature and electrical isolation at all the vein orifices ablated by ultrasound but one superior vena cava,and there was no case with stenosis of the vein after the ablation.It is difficult to get same result and easy to cause stenosis by radiofrequency.Conclusion:Catheter ablation by ultrasound seems to be an easy and safe method to get effective electrical isolation in treatment of focally initiated atrial fibrillation and does not cause stenosis,it is better than that by radiofrequency.更多还原