补充线性消融房室结双径路残存慢径的临床分析  

Treatment of Additional Straight Linear Approach in Atrioventricular Nodal Dual Path-Ways after Radiofrequency Ablation of the Slow Pathway

作　　者：李兆伟[1] 刘俊[1] 陈金国[1] 陶春明[1] 周利民[1] 张军[1] 沈童童[1] 

机构地区：[1]安徽医科大学滁州临床学院心内科,239000

出　　处：《中华全科医学》2011年第7期1020-1021,共2页Chinese Journal of General Practice

摘　　要：目的探讨房室结折返性心动过速(AVNRT)经常规方法消融后残存慢径采取Koch三角基底部补充线性消融后电生理特性变化以及临床疗效。方法将160例AVNRT经常规方法消融成功后残存慢径患者49例,随机分为线性消融组(25例)和对照组(24例)。电生理检查分别记录线性消融前两组残存慢径路有效不应期(ERP)以及最大AH间期(A-Hmax),线性消融组残存慢径阻断率(如经线性消融残存慢径未能阻断则记录慢径路的ERP和A-Hmax的改变情况)以及两组复发情况。结果对照组残存慢径路平均ERP为(288.6±56.0)ms,平均A-Hmax为(306.9±52.0)ms。线性消融组补充消融前慢径路平均ERP为(279.0±45.0)ms,平均A-Hmax为(312.9±66.8)ms,两组术前各项参数比较差异无统计学意义(P>0.05)。线性消融组补充消融后15例慢径路阻断,未能阻断的10例慢径路平均ERP增加至(310.6±67.0)ms,平均A-Hmax缩短为(280.9±52.0)ms,与对照组比较差异具有统计学意义(P<0.05)。线性消融组术中1例出现一过性Ⅲ度AVB,停止放电后恢复正常。随访1年,对照组有4例复发,线性消融组无复发,差异具有统计学意义(P<0.05)。结论采取Koch三角基底部线性消融改良房室结双径路是提高射频消融治疗AVNRT成功率的一种安全有效的方法,可作为常规消融法的补充术式。Objective To investigate the atrioventricular nodal reentrant tachycardia conventional method of residual slow pathway after ablation linear approach in the Koch＇s triangle changes in electrophysiological properties and clinical efficacy.Methods Among 160 patients with AVNRT after successful ablation by conventional methods,the 49 patients with residual slow pathway were randomly allocated to the linear ablation group（25 cases） and control group（24 cases）.Electrophysiology ablation were recorded before the two remaining slow pathway effective refractory period（ERP） and the maximum AH interval（A-Hmax）,residual slow pathway ablation group blocking rate,such as failure to stop residual slow pathway off the record,the average ERP of slow pathway,and A-Hmax changes as well as follow-up period without recurrence of tachycardia were recorded.Results In control group mean slow pathway effective refractory period was（288.6±56.0） ms,average maximum A-H interval was（306.9±52.0） ms.Additional linear ablation group before ablation of slow pathway effective refractory period of the average（279.0±45.0） ms,average maximum A-H interval was（312.9±66.8） ms,the parameters of the two groups before surgery was no significant difference（P0.05）.Additional linear ablation group,15 patients after ablation of slow pathway blocked,not blocked an average of 10 cases of slow pathway effective refractory period increased to（310.6±67.0） ms,average maximum AH interval shortened to（280.9±52.0） ms,with the control group statistically significant difference occurred（P0.05）.Intraoperative linear ablation group 1 patient had transient Ⅲ AVB,stopped the discharge back to normal.Follow-up year,the control group and the linear ablation group were 4 cases and 0 case of relapse,with a significant difference（P0.05）.Conclusion Adopt linear approach in the Koch＇s triangle improved the treatment of dual atrioventricular node pathways AVNRT in a safe and effective method,which can be used as suppl

关 键 词：线性消融 房室结折返性心动过速 房室结慢径路 

分 类 号：R541.71[医药卫生—心血管疾病]