单纯室上速消融治疗阵发性室上性心动过速合并房性心律失常的疗效观察  

The efficacy of simple supraventricular tachycardia ablation in treating paroxysmal supraventricular tachycardia complicating atrial arrhythmia

作　　者：陈丽华[1] 卫展扬[1] 莫静兰[1] 叶健烽[1] 

机构地区：[1]东莞市人民医院心血管内科,广东东莞523000

出　　处：《实用心电学杂志》2017年第5期331-334,共4页Journal of Practical Electrocardiology

摘　　要：目的评估单纯室上速消融(旁道消融或慢径改良)在阵发性室上性心动过速(paroxysmal supraventricular tachycardia,PSVT)合并房性心律失常的治疗上的有效性及安全性。方法对36例经无创及有创电生理检查明确为阵发性室上性心动过速合并房性心律失常的患者进行单纯旁道消融或慢径改良,随访5~48个月,收集患者心律失常的发作及治疗情况。结果 36例中2例室上速复发(房室折返性心动过速、房室结折返性心动过速各1例),经再次消融后无复发;1例出现典型房扑复发,经电生理检查明确为右房峡部依赖型房扑,给予三尖瓣峡部消融处理;另2例有阵发房颤发作,均使用抗心律失常药物治疗;其余31例未发作快速性心律失常;所有患者均未出现明显手术并发症。结论通过单纯室上速消融可以有效减少PSVT合并房性心律失常患者的房性心律失常复发率。Objective To evaluate the efficacy and safety of simple supraventricular tachycardia ablation（ accessory pathway ablation or slow pathway modification） in treating paroxysmal supraventricular tachycardia（ PSVT） complicating atrial arrhythmia. Methods A total of 36 patients were carried out simple accessory pathway ablation or slow pathway modification. They had been specifically diagnosed with PSVT and atrial arrhythmia by non-invasive or invasive electrophysiological examination. The patients were followed up for 5 to 48 months to collect information about the onset and treatment of arrhythmia. Results Among the 36 patients,recrudescence of PSVT was observed in two cases（ one case with atrioventricular reentrant tachycardia and another with atrioventricular nodal reentrant tachycardia）,and both of them were cured by re-ablation. Typical atrial flutter reoccurred in one case,which was specifically diagnosed as being right atrial isthmus dependent by electrophysiological examination. The case was given linear ablation of tricuspid valve isthmus. Paroxysmal atrial fibrillation attacked another two cases who were both given antiarrhythmic drug therapy.Tachyarrhythmia was not observed in the rest of 31 cases. No obvious surgical complication occurred in any patient. Conclusion Simple supraventricular tachycardia ablation proves to be effective inreducing the recurrence rate of atrial arrhythmia among the patients with PSVT complicating atrial arrhythmia.

关 键 词：阵发性室上速 房性心律失常 旁道消融 慢径改良 

分 类 号：R541.7[医药卫生—心血管疾病]