房室结折返性心动过速慢径消融终点与复发的关系  

Study of endpoints of slow atrioventricular nodal pathway ablation in patients with atrioventricular nodal reentrant tachycardia

作　　者：张丽娜[1,2] 刘雄涛[1] 王毅[1] 李军[1] 郑强荪[1] 

机构地区：[1]第四军医大学唐都医院心脏内科,陕西西安710038 [2]解放军第二炮兵总医院心脏内科,北京100088

出　　处：《心脏杂志》2010年第6期878-880,共3页Chinese Heart Journal

摘　　要：目的:观察房室结折返性心动过速(AVNRT)的慢径消融终点与复发的联系。方法:534个慢-快型AVNRT患者行慢径消融治疗,观察A型终点(彻底消融慢径,房室结无跳无折)和B型终点(残留慢径有或无1～3心房回波,不能诱发AVNRT)与AVNRT复发的联系及对房室结传导的影响。结果:①A型复发5例(1.2%),B型复发11例(9.4%),差异有统计学意义(P<0.05)。②A型终点房室结前传文氏周期(Wen-AVN)、快径前传有效不应期和房室结双径路(DAVNP)的跳跃增值缩短,B型快径前传有效不应期和房室结双径路的跳跃增值缩短,A型有效不应期的缩短明显大于B型。结论:A型终点的复发率明显低于B型终点;只要改变房室传导功能,不能诱发心动过速,B型终点仍然是有效、可靠的消融终点。AIM： To study the relationship between endpoints of slow atrioventricular nodal pathway ablation and recurrence in patients with atrioventricular nodal reentrant tachycardia （AVNRT）. METHODS： Slow pathway radiofrequency ablation was performed in 534 patients with slow-fast AVNRT and the effect of endpoint was observed in type A （complete disappearance of slow pathways and inducible AVNRT with no jumping phenomenon and AVN echo） and type B （residual slow pathway conduction without inducible AVNRT）. RESULTS： Endpoint A recurred in 5/415 cases （1.2%） and endpoint B recurred in 11/117 cases （9.4%） with significant differences between them. AV1 ： 1CL, FP-ERP and ΔA2H2 of endpoint A became shorter and FP-ERP and Δ A2H2 of endpoint B became shorter, but ΔFP-ERP of endpoint A was longer than endpoint B. CONCLUSION ： The recurrence rate of type A is lower than that of type B. Type B can be an effective and safe ablation endpoint with good AV conduction and no inducible AVNRT.

关 键 词：导管射频消融术 房室结折返性心动过速 残留慢径传导 

分 类 号：R541.71[医药卫生—心血管疾病]