不同特征的慢电位在房室结双径路患者慢径消融中的价值

The value of different slow potentials characteristics in the slow pathway radiofrequency catheter ablation of dual atrioventricular node pathways

目的本文探讨以不同特征的慢电位为靶点消融慢径的临床意义。方法65例房室结折返性心动过速患者,比较以碎裂电位消融(A组,n=25)、先高频后低频的心房双电位(HL型DPs)消融(B组,n=20)和先低频后高频的心房双电位(LH型DPs)消融(C组,n=6)的有效靶点率、成功率。结果碎裂电位组有效靶点率71.36%,消融成功率92.31%,HL型DPs组有效靶点率87.80%,消融成功率100%,LH型DPs组有效靶点率9.72%,消融成功率0,以慢电位为靶点消融均无房室传导阻滞发生。结论以HL型DPs和碎裂电位为靶点消融慢径安全有效,而以LH型DPs为靶点消融慢径成功率低。

Objective To evaluate the value of different slow potentials characteristics in the slow pathway radiofrequency catheter ablation of dual atrioventricular node pathways. Methods Sixty five patients with atrioventricular node reentrant tachycardia （AVNRT） were studied. Compare the value of different target of fractionated electrograms （FEs） （group A, n=25 ）, high-frequency component followed by a low-frequency component （DPs in HL type） （group B, n= 20） and low-frequency component followed by a high-frequency component （DPs in LH type）（group C, n=6） for success ablation. Results The effective target sites rate of the fractionated electrograms was 71.36%, ablation success rate is 92.31%; 87.80% and 100.00% as to the group of DPs in HL type, 9.72% and 0 as to group of LHs in DP type. There is no A-V block in the whole process. Conclusion It is safe and effective to take utility of DPs in HL type and fractionated electrograms as target in slow pathway ablation; however, the success rate of the slow pathway ablation which regards the DPs in LH type as the target is low.