靶点旁补充消融法在AVRT术中的应用分析  

作　　者：徐光泽 陈治奎[1] 葛世俊[1] 麻付胜[1] 沈文均[1] 廉姜芳[1] 

机构地区：[1]浙江省宁波市医疗中心李惠利医院,315043

出　　处：《浙江临床医学》2021年第1期62-64,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划A类项目(2019KY186)。

摘　　要：目的比较两种不同射频消融方法的有效性和安全性,指导提高房室折返性心动过速(AVRT)射频消融的成功率。方法回顾分析1712例(1741条旁路)连续性AVRT或者预激患者的临床资料,根据不同射频消融手术方法分为S组和M组;S组882例,898条旁路;M组830例,843条旁路,术后观察1~24个月。对比分析两组患者2年观察期内的复发率及并发症的发生率。结果M组观察期各个节点消融累计复发率均显著低于S组,术后第1、3、6、12、24个月累计复发旁路数(率)分别为4(0.5%)vs 17(1.9%),P=0.007;5(0.6%)vs 27(3.0%),P<0.001;6(0.7%)vs 34(3.8%),P<0.001;6(0.7%)vs 58(6.5%),P<0.001;7(0.8%)vs 63(7.1%),P<0.001;不同术式组间的安全性相当。结论靶点旁补充消融法能显著降低AVRT射频消融复发率,且不增加并发症风险,具备操作的可行性。Objective To compare the efficacy and safety of two different radiofrequency ablation methods.Methods 1712 consecutive cases of AVRT with 1741 accessory pathways(Aps)were analyzed in our retrospectively observational study.They were divided into group S and group M(undergone complementary abladon)according to different strategies of radiofrequcncy catheter ablation.882 cases with 898 Aps were enrolled in group S versus 830 cases in group M with 843 Aps.Results The cumulative recurrence rate of ablation in all the observation periods of group M was significantly lower than that of group S,and the cumulative recurrence number(rate)at the 1st,3rd,6th,12th and 24th months were 4(0.5%)vs 17(1.9%)P=0.007,5(0.6%)vs 27(3.0%)P=0.000,6(0.7%)vs 34(3.8%)P=0.000,6(0.7%)vs 58(6.5%)P=0.000,7(0.8%)vs 63(7.1%)P=0.000,respectively.The Chest pain,vasovagal reaction,steam pop,coronary artery spasm,angina pectoris,and embolism were rare in both groups.No Valve damage,myocardial infarction,pericardial tamponade,periprocedural death or other serious adverse events occurred in the two groups.The safety was comparable between the two groups.Conclusion The strategy of complementary ablation significantly reduces the recurrence rate of AVRT radiofrequency ablation without increasing the risk of complications.

关 键 词：房室旁路 补点消融 复发并 发症 

分 类 号：R54[医药卫生—心血管疾病]