射频消融治疗不能诱发的室上性心动过速患者的远期效果

Long-term efficacy of radiofrequency catheter ablation in patients with noninducible supraventricular tachycardia.

目的探讨导管射频消融慢径路在具有房室结双径路和有记录的不能诱发的室上性心动过速(PSVT)患者中的作用。方法在基础状态或静脉应用异丙肾上腺素后,对49例不能诱发PSVT患者(A组)给以程控电刺激,13例可诱发单次房室结回波,9例诱发了两次回波;与49例年龄、性别匹配的可诱发PSVT的患者(B组)进行临床和电生理特征的对比。结果两组患者的快、慢径路的电生理特性无明显差异,射频消融在所有患者中都阻断了慢径路。在随访的(38±5)个月中,两组均未再次发作。结论在具有房室结双径路的有记录的不能诱发的PSVT患者中,导管射频消融慢径路在长期预防心动过速时是有效的。

Objective To explore the long-term efficacy of radiofrequency catheter ablation of slow-pathway in patients with dual atrioventricular node pathways and documented noninducible paroxysmal supraventricular tachycardia （PSVT）. Methods Forty-nine patients with noninducible PSVT and dual atrioventricular node pathways were prospectively studied （group A） , among whom, programmed electrical stimulation induced a single atrioventricular node echo beat in 13 patients and double echo beats in 9 cases. The clinical and electrophysiological characteristics of group A were compared with those of age- and gender-matched patients with inducible PSVT { group B ）. Resuits There were no significant diffcrences in the electrophysiologieal properties of the fast-and slow-pathways between groups. Catheter ablation eliminated the slow-pathway in all patients. There was no recurrence of PSVT in group A or B during the follow-up periods [ （38 ＋ 5） months]. Conclusion In patients with dual atrioventricular node pathways and a documented but noninducible PSVT, catheter ablation of slow-pathway is highly effective in preventing the tachyeardia.