右侧房室旁路射频消融术后复发原因分析  

Analysis of the factors for recurrence of right atrioventricular accessory pathway after radiofrequency catheter ablation

作　　者：杨晓云[1] 柯辉[1] 白融[1] 刘启功[1] 王琳[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院心内科,武汉430030

出　　处：《临床心血管病杂志》2008年第12期906-908,共3页Journal of Clinical Cardiology

摘　　要：目的：分析右侧房室旁路射频消融术后复发原因,提高射频消融术的成功率。方法：对1992年1月~2006年12月行射频消融术房室旁路进行回顾性分析,对比分析左、右侧房室旁路及右侧房室旁路中复发组、非复发组的旁路电位、手术时间、X线曝光时间、放电功率、有效消融时间〉5 s和多条旁路的发生率。结果：右侧房室旁路的复发率（14/112例,12.5%）明显高于左侧（13/536例,2.43%）,P〈0.01;右侧房室旁路的手术时间、X线曝光时间和多条旁路的发生率亦均明显高于左侧（P〈0.01）。右侧房室旁路患者中,复发组多条旁路的发生率[5例（35.71%）]和有效消融时间超过5 s[10例（71.43%）]的患者均明显多于非复发组[4例（4.08%）、7例（7.14%）],P〈0.01,而旁路电位的出现率[28.57%（4例）]却明显低于非复发组[66.32%（65例）],P〈0.05。结论：右侧房室旁路射频消融术后复发率高与其解剖部位、定位标测不准及存在多条旁路有关。Objective：To analyze the factors for recurrence of right atrioventricular accessory pathway after radiofrequency catheter ablation （RFCA） in order to elevate the profitable effects on RFCA. Method： From 1992-01 to 2006-12 there were 112 patients with right atrioventricular accessory pathway were enrolled. The patients were divided in two groups： recurrence and non recurrence. The clinical character and the factors for recurrence were analyzed. Result：During 2 to 36 months＇ follow-up, recurrences were found in 14 cases. The recurrent rate of right atrioventricular accessory pathway among 112 patients was 12.5%. The procedure duration ,X ray exposure time and the incidence of multiple accessory pathways in patients with right atrioventricular accessory pathway was more than those in patients with left atrioventricular accessory pathway （P〈0.01）. The incidence of multiple accessory pathways and immediate success time more than 5 s in the group with recurrence was more than those in the group with non-recurrence. The frequence of accessory pathway potential in the group with recurrence was less marked than that in the group with non-recurrence. Conclusion：The high recurrence in the patients with right atrio ventricular accessory pathway after RFCA is related to the anatomical position , difficult to get to the target sites, and multiple accessory pathways.

关 键 词：导管射频消融 右侧房室旁路 复发 

分 类 号：R816.2[医药卫生—放射医学]