射频消融治疗阵发性室上性心动过速103例回顾分析

The radiofrequency catheter ablation of PSVT: retrospective analysis of 103 cases

目的总结阵发性室上性心动过速(PSVT)的射频消融(RFCA)治疗的临床经验。方法对103例行RFCA的PSVT患者的射频消融方法、成功率、复发率及并发症等进行回顾性分析。结果103例室上性心动过速中房室结折返性心动过速(AVNRT)38例,房室旁路折返性心动过速(AVRT)65例,消融总成功率89%。随访20.6±24.7个月,AVNRT消融复发率16.7%,永久性Ⅲ度房室传导阻滞(AVB)发生率5.3%;AVRT消融复发率3.6%,永久性Ⅲ度AVB发生率1.5%。结论导管射频消融(RFCA)治疗PSVT安全、有效;熟练的心导管技术、仔细的电生理检查、耐心地寻找最满意的靶点图以及合适的消融能量和时间是提高成功率及最大限度地减少并发症的关键。

Objective To summarize the experience of radiofrequency catheter ablation (RFCA) for the treatment of paroxysmal supraventricular tachycardia(PSVT).Methods Retrospectively analyse the methods, successful and recurrence rate and clinical complication of radiofrequency catheter ablation (RFCA) for the treatment of 103 patients with paroxysmal supraventricular tachycardia(PSVT).Results One hundred and three patients with PSVT including atrioventricular reentrant in 65 and atrioventricular nodal reentrant tachycardia (AVNRT) in 38 by results of electrophysiological mapping, underwent RFCA procedures. The total successful rate was 89%. During a mean follow-up of 20.6±24.7 months, the recurrence rate of ablating AVNRT was 16.7%,the rate of permanent Ⅲ° atrioventricular block (AVB) was 5.3%, and the recurrence rate of ablating accessory pathway was 3.6%, the rate of permanent Ⅲ° AVB was 1.5%.Conclusions RFCA for the treatment of PSVT is effective and safe. Accurate mapping, careful and skillful manipulating, and strict control of energy and time during ablation should improve success rates, and decrease the complication in large extent.