RFCA治疗快速性心律失常的临床分析  

Clinical Analysis on Radiofrequency Catheter Ablation for Patients with Tachycardia

作　　者：盖起明[1,2] 薛强[1,2] 左明鲜[1,2] 邓洁 尹昵[1,2] 张小勇[1,2] 

机构地区：[1]昆明医学院附属延安医院心内科 [2]云南心血管病医院,云南昆明650051

出　　处：《昆明医学院学报》2010年第8期88-92,共5页Journal of Kunming Medical College

摘　　要：目的分析总结经导管射频消融(RFCA)治疗快速性心律失常的疗效,以进一步指导临床工作.方法对我科开展射频消融治疗快速性心律失常15a的工作进行总结,对1847例患者的治疗结果进行回顾性分析.结果房室折返性心动过速(AVRT)患者810例,计有旁道869条,其中左侧旁道532例,右侧旁道278例,其中双旁道15例,房室结双径路合并房室旁道21例.房室结内折返性心动过速(AVNRT)753例.室性心动过速VT和室性早搏(PVT)139例,房性心动过速(AT)29例,心房扑动(AF)32例,心房颤动(A)f84例.射频消融总成功率为97.67%,其中房室结双径路和左侧房室旁道所致的阵发性室上速射频消融成功率高达99%.射频消融术后复发率为2.22%.并发症发生率为3.14%,其中1例患者并发永久性Ⅲ°房室传导阻滞而安置永久性心脏起搏器,无死亡病例.结论射频消融治疗快速性心律失常安全、有效、成功率高、并发症发生率及复发率低.适合于各类人群,以AVRT和AVNRT的疗效最佳.并且能够成为快速性心律失常的治疗首选。Objective To analyze the outcomes of patients with tachycardia who underwent radiofrequecy catheter ablation and provide guidelines for further clinical works.Methods The clinical experiences of radiofrequency catheter ablation for patients with tachycardia in our department during 15 years were summarized.The clinical outcomes of 1847 patients with tachycardia who underwent radiofrequency catheter ablation were retrospectively analyzed.Results There were 810 patients with AVRT who had 869 accessory pathways,among them,532 cases with left accessory pathways,278 cases with right accessory pathways,15 cases with bilateral accessory pathways,and 21 cases with dual A-V nodal pathways and accessory pathways.There were also 753 patients with atrioventricular nodal reentrant tachycardia（AVNRT）,139 patients with ventricular tachycardia（VT） and premature ventricular beats,29 patients with atrial tachycardia（AT）,32 patients with atrial flutter（AF）,84 patients with atrial fibrillation（A）f enrolled in this study.The overall success rate was 97.67%,in which radiofrequency catheter ablation of paroxysmal supraventricular tachycardia mediated by dual atrioventricular nodal and accessory pathway had a higher success rate（above 99%）.The recurrence rate was 2.22% after radiofrequency catheter ablation.The incidence of complication s was 3.14%.Only one patient was implanted with pacemaker due to complete atrioventricular block.No patients died.Conclusion Radiofrequency catheter ablation is an effective and safe therapeutic method with high success rate,low incidence of complications,and low recurrence rat for patients with tachycardia,especially for patients with AVNRT and AVRT.It is the optimical therapy for patients with tarchycardia.

关 键 词：心律失常 射频消融 治疗效果 并发症 

分 类 号：R541.71[医药卫生—心血管疾病]