导管法射频消融治疗老年人快速性心律失常

Radiofrequency catheter ablation for tachycardia in elderly patients

目的观察导管法射频消融(RFCA)治疗老年人快速性心律失常的安全性和有效性。方法老年人快速性心律失常患者40例,年龄60～82岁,平均(65±6.3)岁,男23例,女17例。常规电生理检查后行导管法射频消融治疗。结果电生理检查结果显示右侧旁路(RAP)3例,左侧旁路(LAP)11例,房室结折返性心动过速(AVNRT)21例(其中慢慢型AVNRT3例),房速1例,房扑(AF)3例,左室特发性室速(ILVT)1例。40例老年患者消融成功39例,成功率97.5%,1例AF患者消融失败;2月后1例房扑患者复发,再次消融成功。2例出现血管并发症,均为股动脉血肿。术后随访6月～5年,成功消融患者均无心律失常复发,无其他消融相关并发症出现。结论导管法射频消融治疗老年人快速性心律失常安全、有效。

Objective To investigate the effect and safety of radiofrequency catheter ablation(RFCA) for tachycardia in elderly patients. Methods Forty elderly patients with tachycardia, aged 60-82 years (mean 65±6.3 years), male 23 and female 17, underwent electrophysiologic study(EPS) and RFCA. Results EPS were predisposed tachycardia, among them, 3 cases of right lateral accessory pathway(RAP) , 11 cases of left lateral accessory pathway(LAP), atrioventricular node reentrant tachycardia(AVNRT) 21 cases(slower-slower pathway 3 patients), atrial tachycardia 1 case and atrial fullfer(AF) 3 cases, ventricular tachycardia 1 case. Thirty-nine patients were successfully ablated without complications and the success rate of ablation was 97.5%. One case of AF recurred 2 months after ablation and underwent successful ablation again. During follow-up of 6 months-5 years, there was no tachycardia recurrence in any patients. Conclusions RFCA for curing of SVT in elderly patients is effective and safe.