MANAGEMENT OF SOME SPECIAL PROBLEMS IN RADIOFREQUENCY ABLATION

<正> At present,radiofrequency abtation has being the first method for treatment of WPWsyndrome and dual AVN pathway with reentrant supraventricular tachycardia.Review 110cases in our hospital,there are some special problems.Reported here:1.Patient with DDO permanent pacemaker.The function of pacemanker was interfered byradiofrequency cunrrent and changed to DOO.It recurvered Immedlally after discharge.Longtimes follow up there is no desfunction of the pacemaker.2:WPW with paroxysmal atrial fibrMation:Two weeks before ablation,oral amiodaron(200-400mg a day)can effective prevent the occurmence of atrial fibrMation.3.D not appear accessory pathway reterograde:During precedure,when accessorypathway reterograde do not appear,Intravenous lsoptin drip can prolong the refractoryperiod of AVN.It can cause reappearance of the accessory pathway reterograde.4:"Slow conduction"In accessory pathway.As discharge repeatedly at target,conduction ofaccessory pathway was slower.But SVT can still be induced.The YA(or AV)of tapget is notmiscible.Distinguish of the earlist A(or V)is the key of successful abtation.5.Accessory pathway with dual AVN pathway:Phttents with accessory pathway can withdual AVN pathway.Most of them are no clinical significance.Weather ablation or not,atsame time,is decided by the induction of AVNRT.6.Dual AVN pathway with AV block:Dual AVN pathway with AH prolonged slightly is not acontraindication of abletion.But the target should be far from the bundle of His.Lower powerand shorter time should be given and closely observe the change of AV interval.