房室结折返性心动过速消融术中无交界区心律患者的临床特征及消融策略  

Ablation strategy in patients with atrioventricular nodal reentrant tachycardia without junctional rhythm

作　　者：朱伯谦 王沛 宋兵战 陆敬平 卢鑫 丁峣 陈凯 ZHU Boqian;WANG Pei;SONG Bingzhan;LU Jingping;LU Xin;DING Yao;CHEN Kai(Department of Cardiology,Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Provincial Hospital of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院/江苏省中医院心内科,江苏南京210029

出　　处：《现代医学》2024年第6期827-830,共4页Modern Medical Journal

基　　金：国家自然科学基金青年项目(81900237);江苏省自然科学基金青年项目(BK20191093);江苏省中医院高峰人才项目(y2021rc40);江苏省中医药科技发展计划项目(QN202311)。

摘　　要：目的:探讨房室结折返性心动过速(atrioventricular nodal reentrant tachycardia, AVNRT)消融术中无交界区心律(junctional rhythm, JR)患者的临床和电生理特点及消融策略。方法:纳入2014年1月至2023年6月在江苏省中医院心内科行电生理检查诊断为AVNRT患者276例,接受射频消融治疗,分析消融过程无JR患者临床和电生理特点。结果:无JR组共6例患者,与消融中有JR组患者年龄、性别、合并疾病等无明显差别,无JR组患者基础心率更高、成功消融靶点A/V比例更大、消融时间更长。结论:AVNRT消融术中无JR患者相对少见,对于AVNRT消融过程中无JR患者应在每次消融后进行电生理检查诱发心动过速,避免过度消融引起并发症。Objective:To investigate the clinical and electrophysiological characteristics and ablation strategies of patients without junctional rhythm(JR)during ablation of atrioventricular nodal reentrant tachycardia(AVNRT).Methods:The study included 276 patients diagnosed with ANVRT who underwent electrophysiological examination and received radiofrequency ablation treatment in the Cardiology Department of Jiangsu Province Hospital of Chinese Medicine from January 2014 to June 2023.The clinical and electrophysiological characteristics of patients without JR during the ablation process were analyzed.Results:There were 6 cases in the non-JR group,and there was no significant difference in age,gender,comorbidities between the non-JR group and the JR group.Patients in the non-JR group had a higher basal heart rate,a larger A/V ratio of successful ablation targets and longer ablation time.Conclusion:Patients without JR during AVNRT ablation are relatively rare.For patients without JR during AVNRT ablation,electrophysiological study should be performed after each ablation to induce tachycardia and avoid complications caused by excessive ablation.

关 键 词：房室结折返性心动过速 电生理检查 射频消融 交界区心律 

分 类 号：R541.71[医药卫生—心血管疾病]