影响房室旁路导管射频消融术复发因素的分析

Analysis on the recurrent factors of atrioventricular accessory pathways after successful radiofrequency cathater ablation

对１３例导管射频消融术（ＲＦＣＡ）后复发病例资料进行回顾性分析并与２３７例未复发者进行比较，旨在为进一步降低复发率提供线索．结果：性别、心动过速病史及心动过速频率与复发率无关（Ｐ＞０．０５）；成年组复发率高于童年及老年组（Ｐ＜０．０５）；前５０例ＲＦＣＡ患者复发率高于后２００例（Ｐ＜０．０５）复发组的房室波比值、房室融合波时限、融合波提前程度与对照组有显著差异性（Ｐ＜０．０５）；慢旁路的复发率高于普通旁路（Ｐ＜０．０５）；普通旁路之间、不同部位的旁路之间的复发率无显著差异性（Ｐ＞０．０５）；复发组的手术时间、Ｘ线曝光时间、放电有效时间、放电次数、射频电流的功率及能量均高于对照组（Ｐ＜０．０５），阻抗无显著差异性（Ｐ＞０．０５）．结论：术者的经验及靶点图特点是影响复发的主要因素；放电有效所需时间越长，复发可能越大．

The data of 13 recurrent cases after successful radiofrequency cathater ablation(RFCA)were analyzed retrospectively and compared with those of 237 sucessful cases without recurrence in this article, in order to provide clues for reducing the recurrent rate as more as possible.Results: Sex,the duration of history and the rate of the tachycardia had no relation with recurrence (P>0.05);the ratio of A: V,the duration of AV fusing wave and the prior degree of AV fusing wave in reccurrent group had significant difference with those in control group(P<0.05);slow accessory pathways (APs)had higher recurrent rate than ordinary APs ( P < 0. 05); adult had higher recurrent rate than children and senile group(P<0. 05);the former 50 cases had higher recurrent rate than the latter 200 cases( P <0. 05);among the different locations of ordinary Aps there was no difference(P<0. 05);the duration of operation,X-ray exposure; effective discharge and the duration of discharge, the power and energy of radiofrequency current in recurrent group were much more than those of control group( P<0. 05);impedances had no significant difference in the two groups( P >0. 05). Conclusion:The experience of operators and the features of target site rnap were the main factors which influenced the recurrent rate;the longer time of effective discharge was delivered,the more possibility of reccurrence could be seen.