阵发性房室结折返性心动过速慢径路消融过程中交界心律的临床价值

The clinical value of junctional rhythm in the process of slow-pathway ablation in atrioventricular nodal reentrant tachycardia

目的:进一步明确在慢径消融过程中出现交界心律的临床价值。方法:回顾性分析我科1996年1月至2006年1月采用射频消融治疗的阵发性房室结折返性心动过速(AVNRT)患者425例。在慢径路消融过程中,以交界心律出现与否作为观察指标,按照常规的慢径路消融成功标准进行比较。结果:以交界心律出现与否作为观察指标,预示消融成功的敏感性97.91%,特异性68.67%,阳性预测值68.37%,阴性预测值97.94%,正确诊断指数0.67。结论:慢径路消融成功的病例在消融过程中大多出现交界心律,但交界心律的出现不能作为消融成功的终点;未出现交界心律提示我们需要重新调整导管的位置,寻找更有效的靶点。

Objective：The aim of the study was to investigate the clinical value of junctional rhythm in slow- pathway ablation of atrioventrieular nodal reentrant taehyeardia. Method： from January 1996 to January 2006,425 patients with atrioventrieular nodal reentrant taehyeardia were included . Radiofrequeney ablation of slow-pathway was performed. The presence or absence of junctional rhythm was observed and compared with the routine success endpoint. Result：Calculated sensitivity of junctional rhythm as an indicator of successful ablation was 97.91% with a negative predictive value of 97.94 % . Specificity was lower at 68.67 % with a positive predictive value of 68.37 % . The diagnostic accuracy was 0.67. Conclusion： Junctional rhythm is often present in the process of successful slow- pathway ablation in atrioventrieular nodal reentrant tachyeardia.The absence of junctional rhythm indicates that further applications are required for successful endpoint.