快—慢综合征的临床特点及射频消融治疗

The clinical characteristics of tachy-bradycardia syndrome and its radiofrequency ablation

目的 分析快—慢综合征的临床特点 ,探讨其发生机制及治疗。方法 术前停用抗心律失常药物至少 5个半衰期 ,常规进行心脏彩超及动态心电图检查 ,年龄 >5 0岁者行冠状动脉造影检查 ,进行全面的心内电生理检查和射频消融术。结果 9例患者皆成功进行射频消融术。其中房室旁道 5例 ,左、右房速各 1例 ,房室结双径路 1例 ,Ⅰ型房扑 1例。结论 快—慢综合征以阵发生室上性心律失常及反复晕厥为表现 ,中老年人多见 ,各种电生理机制参与其间 ,病理机制不明 ,常不合并冠心病 ,处理措施首选射频消融术。

Objectives To study the clinical characteristics of tachy-bradycardia syndrome and investigate the mechanism and treatment of this disease. Methods At first,all patients stopped the usage of anti-arrhythmia medicine for at least five half-lifes,at the same time,they were followed up by echocardiography and 24 hour Holter monitoring, and coronary angiography was made in patients older than fifty years,and than,they had accepted electrophysiology check and radiofrequencical catheter ablation(RFCA).Results 9 patients all had successful RFCA,among the 9 patients,5 patlents were atrioventricular accessory pathways,one patient was left-sided atrial tachycardias,one patient was right-sided atrial tachycardias,one was DAVNP. Conclusions The incidence of tachy-bradycardia syndrome probably <0.70%,paroxysmal supraventricular tachycardias and repeatedly syncope are its major symptoms;it usually assocites without coronary atherosclerotic heart disease, and is commonly in middle age and old man; it may have several electrophysiological mechanisms,and its pathological mechanisms is unknown. For its treating RFCA should be the first choice.