射频消融治疗无明显跳跃现象的房室结折返性心动过速

Radifrequency cahteter ablation in the treatment of AVNRT with smooth av nodal function curves

目的：探讨无明显跳跃现象的房室结折返性心动过速（ＡＶＮＲＴ）的本质特点及经导管射频消融（ＲＦＣＡ）的手术终点。 方法：对１１ 例无明显跳跃现象的ＡＶＮＲＴ进行常规的慢径路ＲＦＣＡ治疗，并比较分析手术前后各项心电生理参数。 结果：慢径消融后，代表慢径的平滑的房室结功能曲线的“尾部”消失；房室结有效不应期从（２６９±３７）ｍ ｓ增至（３３８±３１）ｍ ｓ（Ｐ＜ ０．０１）。Ａ－Ｈｍ ａｘ从（２６７±２６）缩短至（２０１±６７）ｍ ｓ（Ｐ＜ ０．０１）。 结论：手术后，平滑的房室结功能曲线的尾部消失，是慢径阻断的可靠指标，可作为ＲＦＣＡ手术终点的标准。

Objectives:The report is intented to discuse the essence of AVNRT with Smooth AV nodal Fuction curves and to evaluate the end point of RFCA in AVNRT. Methods:RFCA was performed in 11 patients of AVNRT with smooth AV nodal function curves and cardiac electrophysiological parameters were compared before and after RFCA. Results:After ablation of slow pathway,the “tial” which represent slow pathway in A V nodal functional curves disapeared.The effective refractor period of AV nodal increaed (269±37 ms vs 338± 31 ms, P <0.01) and the maxmium A H interval decreased (267±26 ms vs 201±67 ms, P <0.01). Conclutions:The “tail” disappearance in smooth AV nodal Function curves after RFCA was a fairly reliable indication which showed slow pathway had been ablated.It is of great importance in determining the end point of RFCA in AVNRT.