射频消融改良房室结控制特发性心房颤动所致快速心室率  

Control of Rapid Ventricular Response by Radiofrequency Catheter Modification of the Atrioventricular Node in Patients With Medically Refractory Atrial Fibrillation

作　　者：杨延宗[1] 林治湖[1] 张树龙[1] 高连君[1] 杨东辉[1] 丛培欣[1] 朱浩[1] 郑晓群[1] 宋道岭[1] 

机构地区：[1]大连医科大学附属第一医院心内科

出　　处：《中国心脏起搏与心电生理杂志》1996年第2期75-77,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：采用射频消融改良房室结的方法控制７例特发性心房颤动（简称房颤）病人的快速心室率。５例持续性房颤在房颤时消融，２例阵发性房颤在窦性心律时消融，平均放电６±４次，６例成功，１例失败。成功的病例术后复查动态心电图示静息时房颤的平均最大心室率和平均心室率分别从术前的１６５±１１和１３６±１０ｂｐｍ下降到１１１±１４和８８±１１ｂｐｍ（Ｐ均＜０．００１）。平均随访５±４月患者无明显症状，不服药静息心室率均低于１１０ｂｐｍ，有１例阵发性房颤发作显著减少。结果提示：对于症状明显、药物治疗无效的特发性快速房颤的病例，射频消融改良房室结是控制心室率安全和有效的方法。Seven patients with rapid ventricular response to atrial fibrillation underwent attempted atrioventricular (AV) node modification using radiofrequency catheter ablation(RFCA) technique.After 1 to 13 deliveries of radiofrequency current,the conducting ability of the AV node in 6 patients was successfully modified.The 12 lead ECG and 24 hour ambulatory ECG were performed before and after the procedure.The maximum ventricular rate was reduced from a mean of 165±11 bpm to 111±14 bpm( P <0.001) and average ventricular rate from a mean of 136±10 bpm to 88±11 bpm after ablation( P <0.001).During the follow up of mean 5±4 months,6 patients remained symptom free from rapid ventricular response in atrial fibrillation without AV node blocking drugs.It is concluded that RFCA modification of AV node conduction is safe and effective in controlling rapid ventricular response to atrial fibrillation in some medically refractory patients.

关 键 词：导管消融 射频电流 心房颤动 心室率 

分 类 号：R541.750.5[医药卫生—心血管疾病]