射频消融治疗房室结折返性心动过速术后复发原因分析  

Analysis of recurrence of atriovenricular nodal reentrant tachycardia after radiofrequency catheter ablation

作　　者：杨海玉[1] 于世龙[2] 曾秋棠[2] 张家明[2] 陈志坚[2] 毛奕[2] 苗立夫[2] 

机构地区：[1]江门市中心医院心内科 [2]华中科技大学同济医学院心血管病研究所

出　　处：《临床心血管病杂志》2001年第5期199-201,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨房室结折返性心动过速 (AVNRT)射频电消融 (RFCA)术后复发原因。方法 :对 2 0 2例A VNRT患者 RFCA术后进行随访 ,回顾性分析其电生理资料。结果 :2 0 2例中 12例复发 ,复发率 5 .9%。复发组7例 (5 8.3% )、非复发组 18例 (9.5 % )靶点数 <3,复发组 9例 (75 .0 % )、非复发组 17例 (8.9% )慢径残存 ,两组比较均差异有非常显著性意义 (P <0 .0 1) ,复发组 2例有明显的慢电位未加消融。结论 :消融靶点数 <3及慢径残存、慢电位靶点处未加消融是 RFCA治疗 AVNRT术后复发的主要原因。Objective:To analysis the factors that were associated with the recurrence of atrioventricular nodal reentrant tachycardia (AVNRT) after selective radiofrequency catheter ablation (RFCA) on the slow pathway. Method:Two hundred and two consecutive patients with AVNRT after radiofrequency of atrioventricular node modification were followed up and their electrophysiologic data were retrospectively investigatd. Result:Clinical recurrence of AVNRT was documented in 12 patients (recurrence group) from 202 patients and no recurrence in 190 patients (no recurrence group). The recurrent rate was 5.9 %.Dual atrioventricular nodal pathway still presented after RFCA in 75% patients of recurrence group. Whereas it was 8.9 % in no recurrence group with significant difference presented between the two group (P< 0.01 ). Two patients with slow potential recurred in recurrence group, patients whose targets ablated less than 3, were 58.3 % in recurrence group, whereas they were 9.5 % in norecurrence group. There was a higher recurrent rate in patients whose targets less than 3 than in those whose targets more than 3 (P< 0.01 ).The AVNRT soon recurred in 2 patients, who had significant slow potential that was not ablated. Conclusion:①In order to eliminate the conduction of slow pathway, ablation must be conducted at least 3 sites. ②Slow potential expresses activity of slow pathway and ablation on slow potential is necessary. ③The physiology of dual pathway of atrioventricular node can not exists.

关 键 词：房室结折返性心动过速 射频导管消融术 复发 

分 类 号：R541.71[医药卫生—心血管疾病]