射频消融慢径路对房室结快径路前传功能的影响

The effect on fast pathway anterograde conduction after radiofrequencey ablation of slow pathway

目的观察房室结折返性心动过速(AVNRT)患者慢径路被消融后对房室结快径路的影响。方法选择94例AVNRT患者,其中男42例,女52例,平均年龄50.06岁,标准差为15.35岁。进行慢径路改良,观察手术前后房室结的前传有效不应期和文氏阻滞点的改变。结果91例患者前传有效不应期从(356.5±54.5)ms缩短为(280±60)ms,文氏阻滞点从(378.3±61.7)ms提前为(337.4±52.6)ms。另外3例患者的前传有效不应期和文氏阻滞点都有延长,他们在术中都出现一过性的P-R间期延长。结论房室结双径路是彼此有相互关联的两条径路,功能慢径的存在可能在一定程度上抑制快径的传导功能,因此慢径路的改良表现出快径路前传功能的改善。

Objective To assess the changes of fast pathway anterograde conduction in patients with atrioventricular nodal reentrant tachycardia underwent ablation of slow pathway. Methods Ninty-four patients with antioventricular nodal reentrant tachycardia,42 males,52 females,underwent ablation of slow pathway. The anterograde effective refractory period and Wenckebach block point were measured before and after ablation. Results There was a significant difference in the anterograde effective refractory period before and after operation [（356.5 ± 54.5） ms vs （280 ± 60） ms,P 〈 0.05] and Wenckebach block point[ （378.3 ± 61.7） ms vs （337.4 ± 52.6） ms,P 〈 0.05]. In other 3 patients the anterograde refractory period and Wen＇s period was increased. Conclusion There is mutual associations in between the fast and slow atrioventricular nodal pathways. The existence of slow pathway may suppress the conduction of fast pathway in certain extent. Thus the operation of ablation slow pathway might improve the conduction of anterograde fast pathway.