导管射频消融术中出现Ⅲ度房室阻滞的预后与对策  

Prognosis and Treatment of Complete Atrioventricular Block in Radiofrequency Catheter Ablation.

作　　者：杜日映[1] 王毅[2] 孟宪章[1] 郑强荪[2] 范作文[1] 薛玉生[2] 

机构地区：[1]青岛心血管病研究所青岛海慈医疗集团心脏内科,山东青岛266033 [2]第四军医大学唐都医院心脏内科,陕西西安710038

出　　处：《中国心脏起搏与心电生理杂志》2001年第6期385-385,共1页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：为了探讨导管射频消融术中出现的Ⅲ度房室阻滞 (AVB)转为永久性Ⅲ度AVB的预测指标与合理对策 ,回顾性地分析了 10年来遇到的 16例患者。术中终止放电后很快恢复了房室传导而术后次日再次发生Ⅲ度AVB 8例 (A组 ) ,终止放电后直至出院 (住院 30～ 80d)始终未恢复房室传导 8例 (B组 )。并对两组的以下指标进行比较 :①性别 ;②年龄 ;③术中发生Ⅲ度AVB的次数 ;④放电中出现连续非 1∶1结性搏动数 ;⑤终止放电后Ⅲ度AVB的持续时间 ;⑥次日再出现Ⅲ度AVB的持续时间 ;⑦是否使用激素。结果表明放电中连续的非 1∶1结性搏动数及Ⅲ度AVB持续的时间是可靠的预测指标 ,一旦出现必须在 3跳内停止放电 ,观察期为一个月 ,否则应安置永久起搏器。To predict prognosis and to take effective treatment for the complete atrioventricular block (CAVB) occurring in radiofrequency catheter ablation,16 patients with the accident in the past ten years were reviewed.Of the 16 patients,8 had transient CAVB which became normal atrioventricular conduction in a few minutes after end of discharge and recurred on next day after operation (Group A) and other 8 had CAVB which occurred at end of discharge and had not changed in hospital on 30～80 days (Group B).The items were compared that were as follows:① sex,② age,③ the times of CAVB occurring in operation,④ the number of no 1∶1 AV nodal beats in discharge of radiofrequency ablation,⑤ the duration of CAVB after end of discharge,⑥ the duration of CAVB occurring again next day,⑦ using hormone or not for treatment of CAVB.④,⑤ items are reliable predictors to prognosis of CAVB.Prevention and right treatment of CAVB are suggested on the basis of these patients and our experience.

关 键 词：Ⅲ度房室阻滞 导管消融 射频电流 结性搏动 

分 类 号：R541.760.7[医药卫生—心血管疾病] R454.1[医药卫生—内科学]