慢径消融治疗不能诱发的房室结折返性心动过速的远期疗效

Long-term Efficacy of Slow-pathway Catheter Ablation in Patients with Documented but Noninducible Artioventricular Nodal Reentrant Tachycardia

目的:探讨有阵发性室上性心动过速(paroxysmal supravrentricular tachycardia,PSVT)病史和房室结双径路,但程序刺激不能诱发房室结折返性心动过速(atrioventricular nodal reentrant tachycardia,AVNRT)患者,进行慢径射频消融治疗的远期疗效。方法:在436例PSVT行慢径路消融治疗的患者中,49例程序刺激不能诱发AVNRT(A组),选择年龄、性别相匹配的、且程序刺激可诱发AVNRT的患者49例作为对照(B组)。比较两组患者快、慢径路的电生理特性及慢径路消融后的远期疗效。结果:①两组患者快、慢径路的电生理特性无明显差异;②所有患者均成功消除慢径路;③平均随访38．5±5个月,无一例PSVT复发。结论:对存在房室结双径路和典型PSVT病史,但程序刺激不能诱发AVNRT发作的患者,慢经路消融具有肯定的远期疗效。

Objective：To investigate the long-term efficacy of radiofrequency catheter ablation of slow-pathway in patients with dual atrioventricular node pathways and a documented paroxysmal supraventricular tachycardia （PSVT） but noninducible atrio- ventricular nodal reentrant tachycardia （AVNRT）. Methods： Forty-nine patients （group A） with documented but noninducible PSVT and dual atrioventricular node pathways were prospectively studied. The clinical and electrophysiological characteristics of group A patients were compared with that of age- and gender-matched patients with dual atrioventricular node pathways but inducible PSVT （group B）. Results：There was no significant difference in the electrophysiological properties of the fast- and slow-pathways between the two 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 of 38. 5 ± 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 tachycardia in long-term.