伴RR间期交替的室上性心动过速的射频消融  

Radiofrenquency ablation of superventricular tachycardia with R-R interval alternation

作　　者：陈良华[1] 刘同宝[1] 宋尚明[1] 唐元升[1] 朱兴雷[1] 

机构地区：[1]山东大学附属省立医院,济南250021

出　　处：《临床心血管病杂志》2010年第7期533-535,共3页Journal of Clinical Cardiology

摘　　要：目的:探讨伴RR间期交替的窄QRS波心动过速的电生理机制和射频消融策略。方法:10例伴RR间期交替的心动过速患者接受了电生理检查,明确其心动过速类型后,首先消融旁路或诱发的心动过速,如仍能诱发房室结折返性心动过速(AVNRT)则消融慢径路,并随访了解心动过速复发情况。结果:10例患者中9例为左侧游离壁旁路合并房室结双径路,消融旁路后3例诱发AVNRT,一并成功消融了慢径路,另6例没有诱发AVNRT者未再消融,1例为房室结三径路,成功消融了慢径路。在6个月～8.4年随访中,无心动过速复发。结论:伴RR间期交替的心动过速具共同特点,即存在房室结双径路。在消融基础心动过速后,如不能诱发AVN-RT,可不消融慢径路。Objective：To explore the electrophysiological mechanisms and ablation strategy of superventricular tachycardia with R-R interval alternation.Methods：Ten patients with superventricular tachycardia and simultaneous R-R interval alternation received electrophysiological study and then ablation according to the different type of tachycardia.At first,the accessory pathway or induced tachycardia was treated.However,if atrioventricular nodal renntry tachycardia（AVNRT） was induced,the slow pathway should be ablated at the same time.Results：Of 10 patients,9 patients were with left free wall accessory pathways and AVN double pathways.The accessory pathways were first ablated,and 3 slow pathways inducing AVNRT were also modified,while the rest not inducing AVNRT remained intact.One patient had triple AVN pathways,and the slow pathways were successfully blocked.During the follow-up of 6 months to 8.4 years,there was no recurrence of tachycardia.Conclusion：Tachycardia with R-R interval alternation has a characteristic in common：coexistence of AVN double pathways.After the basic tachycardia is ablated,the slow pathway may not be intervened if it does not induce AVNRT.

关 键 词：心动过速 室上性 导管消融 射频电流 RR间期交替 

分 类 号：R541.71[医药卫生—心血管疾病]