射频消融治疗先天性心脏病伴阵发性室上性心动过速  

Radiofrequency catheter ablation of paroxysmal supraventricular tachycardia in patients with congenital heart disease

作　　者：楚建民[1] 王方正[1] 张奎俊[1] 马坚[1] 李一石[1] 华伟[1] 方丕华[1] 余培贞[1] 王锦志[1] 田瑞国[1] 朱克平[1] 鲁志民[1] 陈新[1] 孙瑞龙[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院,100037

出　　处：《中华心律失常学杂志》1998年第2期105-107,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的评价射频消融治疗先天性心脏病伴阵发性室上性心动过速的疗效和安全性。方法18例先天性心脏病伴阵发性室上性心动过速(8例显性预激综合征)行射频消融治疗,其结果与200例无器质性心脏病者进行对照。结果12例单旁路射频消融成功率为83.3%(10/12),试放电次数(9±6和5±3,P<0.05),手术时间(162±40和121±50分钟,P<0.05)和 X 线爆光时间(53±30和28±17分钟.P<0.05)均大于对照组。6例房室结折返性心动过速,其射频消融成功率83.3%(5/6),试放电次数(5±2和4±3.P>0.05),手术时间(98±32和87±25分钟,P>0.05)和 X 线爆光时间(30±26和20±17分钟,P>0.05)与对照组比较无差别。随访中无并发症发生。结论射频消融治疗对先天性心脏病伴阵发性室上性心动过速患者安全有效。Objective:To study the radiofrequency catheter ablation of paroxysmal supraventricular tachycardia in patients with congenital heart disease.Methods Radiofrequency catheter ablation was per- formed in 18 patients who had congenital heart disease associated with accessory pathway (AP)-mediated tachycardia ( 12 patients),or atrioventricular nodal (AVN) reentrant tachycardia (6 patients).Congenital heart diseases diagnosed were four with Ebstein′s anomaly,six with atrial septal defect ,one with ventricular septal defect ,two with patent ductus arteriosus,one with ventricular septal defect and patent ductus arterio- sus,four with complex congenital heart disease.Results The ablation success rate (83.3%,10/12 vs 97.0%.97/100,P<0.05) is lower,more attempt deliveries of current (9±6 vs 5±3,P<0.05),longer procedure (162±40 vs 121±50minutes,P<0.05)and radiation exposure time (53±30 vs 28±17minutes, P<0.05) were necessary to achieve a high success rate in patients with accessory pathway-mediated tachy- cardia and congenital heart disease.There was no difference in attempt deliveries of current (5±2 vs 4±3, P>0.05),procedure (98±32 vs 87±25minutes,P>0.05) and radiation exposure time (30±26 vs 20± 17minutes,P>0.05),between with and without congential heart disease patients associated with atrioven- tricular nodal reentrant tachycardia.No complications were noted during follow-up period.Conclusion Pa- tients with congenital heart disease and proxysmal supraventricular tachycardia could benefit from radiofre- quency ablation therapy by eliminating the arrhythmia with high success,low recurrence and low complica- tion rates.

关 键 词：先天性心脏病 阵发性室上性心动过速 射频消融治疗 对照组 手术时间 X线 并发症 成功率 无器质性心脏病 预激 

分 类 号：R541[医药卫生—心血管疾病] R654.2[医药卫生—内科学]