温度和病理生理效应的相关性在射频导管切除AV接口的射频导管切除过程中
S Nath1, J P DiMarco, J P Mounsey
1Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, USA.
Circulation
|September 1, 1995
概括
在AV节点的射频消去可以诱导加速的节点节奏和AV节点阻塞. 成功的切除部位的特点是这些节奏的快速发作,并在特定的温度下阻塞.
科学领域:
- 电子生理学 电子生理学
- 心血管医学 心血管医学
背景情况:
- 加快的结节节律通常在AV结节的射频 (RF) 切除过程中先发生AV结节块.
- 诱导这些事件的精确时间和温度值仍然不完全表征.
研究的目的:
- 描述在AV节点的射频消除过程中诱导加速结节节律和AV节点阻塞的时间过程和温度要求.
主要方法:
- 十九名患者使用热敏电阻导管进行射频切除,功率提升到50W.
- 射频应用提供了9秒的时间,功率以5W的增量增加.
- 成功的应用涉及在观察到的功率水平下传输射频,直到发生AV节点阻塞或功率进一步增加.
主要成果:
- 在所有19名患者中,射频消化成功,对于永久的AV节点阻塞,需要平均一次应用.
- 在89%的成功尝试中出现了加速结节节律,平均发病时间为1.8秒.
- 在成功的应用 (19.6秒) 和不成功的应用 (36.8秒) 中,AV节点阻塞显著更快.
- 加速结节律 (51°C) 的导管尖温度低于AV结节块 (58°C).
- 永久的AV节点阻塞需要平均温度在60°C左右.
结论:
- 加速结节节律 (5秒内) 和AV节点阻塞 (30秒内) 的快速发作表明成功的切除目标.
- 加速结节律和AV节点阻塞都是高度依赖温度的现象.
- 与加速结节节律相比,需要更高的温度来诱导AV节点阻塞.
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