摘 要： 1例女性患者，33岁，局灶性心房颤动(简称房颤)的起源部位位于右上肺静脉(RSPV)口。第一次于RSPV内行点状消融短阵房性心动过速的最早兴奋点(较体表心电图P′波提早57 ms)，即刻成功，但术后3日复发。观察一周后仍有房颤发作而行第二次手术。术中因各种方法都不能诱发短阵房性心动过速与房颤，而行RSPV口环状消融。术后随访3个月房颤未复发，患者无任何不适，表明手术成功。结论：导管射频肺静脉口环状消融是相对安全的方法，可以提高导管射频治疗起源于肺静脉口局灶性房颤的成功率，降低复发率。

    分类号： R541.7⁺ 5 文献标识码： A

    文章编号： 1007—2659(2000)01—0023—03

DU Ri-ying XUE Yu-sheng WANG Yi et al.

Abstract ：A patient with focal atrial fibrillation (AF) originating in the right superior pulmonary vein (RSPV) was treated by radiofrequency catheter ablation of RSPV.In first operation discrete radiofrequency ablation of site of the earliest activation of short paroxysmal atrial tachycardia was successful,but AF recurred 3 days later.There was second operation for paroxysms of AF during a week observation.Circumferential radiofrequency ablation at the ostium of RSPV was utilized because short paroxysmal atrial tachycardia and AF were not induced in the operation.No AF recurred and the patient felt very well during 3 months follow-up.Conclusion:Circumferential radiofrequency catheter ablation of pulmonary vein orifice seems to be relatively safe and may increase success rate and decrease recurrent rate in treatment of focal AF from pulmonary vein orifices.[Chinese Journal of Cardiac Pacing and Electrophysiology,2000,14(1):23～25]

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