慢旁道参与的室上性心动过速的电生理特点和导管射频消融治疗  

THE ELECTROPHYSIOLOGIC CHARACTERISTICS OF TACHYCARDIA CAUSED BY SLOW ATRIOVENTRICULAR ACCESSORY PATHWAYS AND ITS MANAGEMENT WITH RADIOFREQUENCY CATHETER ABLATION

作　　者：陈椿[1] 陈明龙[1] 单其俊[1] 邹建刚[1] 曹克将[1] 李文奇[1] 杨兵[1] 黄元铸[1] 

机构地区：[1]南京医科大学第一附属医院,南京210029

出　　处：《江苏临床医学杂志》2002年第1期11-14,共4页Journal of Jiangsu Clinical Medicine

摘　　要：方法 :对 6例慢旁道参与的心动过速的电生理和导管射频消融 (RFCA)治疗。结果 :6例患者的室上性心动过速特点为窄形QRS波 ,RP间期 >PR间期。电生理特点为 :右心室刺激时有与心动过速相同激动顺序的逆传性心房活动 ;心动过速的最短RP间期 >110ms;旁道的逆传具有递减性传导的性质 ;心动过速时与H波同步刺激心室可逆传到心房并使之提前激动并且激动顺序与心动过速时相同 ;6例患者中 ,旁道位于右后间隔 4例、左后间隔 1例、左后侧 1例 ;RFCA可成功阻断所有 6例患者的旁道 ,靶图的特点是VA提前而不融合。结论 :RFCA治疗慢旁道参与的心动过速安全。Objective:This article reported the electrophysiologic characteristics of atrioventricular reentrant supra-ventricular tachycardia (SVT) caused by slow atrioventricular accessory pathways (slow AP) in six patients and the treatment with radiofrequency catheter ablation (RFCA).Methods and Resnks the results showed that the characteristics of tachycardia was narrow QRS wave and RP interval>RP interval in all of them.The electrophysiologic characteristics of slow AP were:①Rretrograde atrial activity sequence which was identical to that of tachycardia was found when right ventricle was stimulated.②The shortest RP interval was more than 110ms during tachycardia or stimulating right ventricle.③the characteristics of slow AP conduction was decremental.④During tachycardia there were abnormal atrial activity site and atrium could be captured when ventricle was stimulated simultaneously with H wave.⑤there were 4 accessory pathways in right posteroseptal position, one in left posteroseptal position and one in left posterior wall.⑥RFCA may successfully block all accessory pathways in the six patients, the characteristics of successful ablation target map was VA earlier than other leads and not confusion of V wave and A wave.Conclusions:RFCA may be safety and efficacy for treating tachycardias caused by slow AP.

关 键 词：慢旁道 射频消融 室上性心动过速 电生理特点 

分 类 号：R541.7[医药卫生—心血管疾病]