| | | | | 射频消融慢径治疗程控不能诱发且没有跳跃的房室结折返性心动过速 | | | 李穗吉;蒋廷波;蒋文平 | | | 目的:评价射频消融慢径治疗程控不能诱发且没有跳跃的房室结折返性心动过速(AVNRT)患者的远期疗效,探讨其电生理机制。方法:临床证实的AVNRT患者101例,在电生理检查中18例程控不能诱发及没有跳跃(A组),19例程控不能诱发(B组),33例程控没有跳跃(C组),31例程控有跳跃并且能诱发(D组)。比较各组电生理的情况及射频消融治疗的远期疗效。结果:术后随访(49.13±30.13)个月,C组1例于术后2个月复发,发生Ⅲ度房室传导阻滞而安装起搏器,D组1例于手术后7个月复发,A、B、C、D组的未复发率均差异无统计学意义(P>0.05)。A、B组与C、D组相比快径逆传功能相对较差,术前B组的快慢径不应期差值较D组小,各组有效消融后交界心律的发生率差异无统计学意义。结论:慢径消融在治疗程控不能诱发及没有跳跃的AVNRT患者是安全有效的。交界性心律可以作为该类患者的射频消融的参考终点。
【作者单位】：苏州大学附属第一医院心内科;苏州大学附属第一医院心内科;苏州大学附属第一医院心内科 江苏苏州;215006;江苏苏州;215006;江苏苏州;215006
【关键词】：房室结折返性心动过速;导管消融术
【分类号】：R541.7
【DOI】：CNKI:SUN:LCXB.0.2008-03-006
【正文快照】：
房室结折返性心动过速(atrioventricular nodalreentrant tachycardia,AVNRT)是阵发性室上性心动过速(PSVT)常见的一种类型,射频消融(RF-CA)是治疗AVNRT的有效手段,成功率96.1%~98·8%〔1,2〕。有效消融后,程控刺激不能再次诱发及跳跃消失是作为AVNRT消融终点的重要判断标准。 | | |
| | |  推荐 下载CAJ全文  下载PDF全文 | | | CAJViewer7.0阅读器支持所有CNKI文件格式，AdobeReader仅支持PDF格式 | | | | Radiofrequency catheter ablation of slow pathway in patients with dual atrioventricular node pathway and a documented but without inducible tachycardia and with smooth atrioventricular nodal function curves | | | LI Suiji JIANG Tingbo JIANG Wenping(Department of Cardiology;the First Affiliated Hospital of Suzhou University;Suzhou;215006;China) | | | Objective:To assess the long-term efficacy of radiofrequency catheter ablation of slow pathway in patients with dual atrioventricular node pathway(DAVNP) and documented but without inducible tachycardia and with smooth atrioventricular nodal function curves.To study it's mechanisms.Method:One hundred and one patients with clinically documented AVNRT underwent successful radiofrequency ablation(RFCA) were included.Patients were divided into four groups.18 patients who had DAVNP but without inducible tachycardia and with smooth atrioventricular nodal function curves are group A;19 patients without inducible AVNRT and without smooth atrioventricular nodal function curves are group B;33 patients with inducible AVNRT but with smooth atrioventricular nodal function curves are group C;31 patients with inducible AVNRT but without smooth atrioventricular nodal function curves are group D.To compare the clinical and electrophysiological characteristics among group A,B,C and D.Result:During(49.13±30.13) months follow-up,none of the 37 patients of group A and B had recurrence of PSVT.However,1 patient of the group C had recurrence of PSVT in 2 months after slow-pathway catheter ablation,and 1 patient of the group D had recurrence of PSVT in 7 months after ablation.There is no significant difference of the recurrence ratio among the four groups(P>0.05).Compare with the groups C and D,group A and B have relatively poor retrograde fast-pathway conduction.There is no significant difference of the occurrence ratio of junctional rhythm or tachycardia in four groups.There is 1 patient of group C attacked with Ⅲ°AVB who implanted pacemaker after catheter ablation.Conclusion:Slow-pathway catheter ablation with radiofrequency is safe and highly effective in eliminating PSVT in which the tachycardia is not inducible and with smooth atrioventricular nodal function curves.The occurrence of junctional rhythm or tachycardia could be taken as the end point of the catheter ablation.
【Keyword】：Atrioventricular nodal reentrant tachycardia;Catheter ablation |
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