心房起搏法在射频消融房室结折返性心动过速中的应用

Application of Atrial Pacing Method in Treatment of Atrioventricular Reentrant Tachycardia by Radiofrequency Catheter Ablation

将射频消融治疗的９４例房室结折返性心动过速（ＡＶＮＲＴ）病人按心房起搏法和常规法进行分组（分别为３９及５５例），回顾性比较两组病人的消融治疗结果，以评价这两种方法在射频消融治疗ＡＶＮＲＴ中的安全性、成功率和复发率。随访１０．８±４．５个月，总成功率为９６．８％、复发率为２．１％。与常规组相比，起搏组有效放电时间明显延长（１４５±３８ｓｖｓ８２±２６ｓ，Ｐ＜０．０１）、慢径阻断成功率高（６１．５％ｖｓ４０．０％，Ｐ＜０．０１）、一过性房室阻滞发生率低（２．６％ｖｓ１２．７％，Ｐ＜０．０５），但各种类型的永久性房室阻滞发生率和复发率无显著性差异（Ｐ＞０．０５）。表明ＡＶＮ－ＲＴ消融术中采用心房起搏法较常规法更为安全有效。

Atrial pacing method(APM) and routine method (RM) were studied retrospectively in treatment of atrioventricular reentrant tachycardia(AVNRT) by radiofrequency catheter ablation (RFCA) to compare safty,successful and recurrence rate.55 patients with AVNRT were treated by RM,and other 39 patients by APM during ablation when fast junctional rhythm sustained.In 94 patients,total successful rate was 96.8%,recurrence rate was 2.1%.Compared with RM group,effective ablation time of APM group was longer (145±38 s vs 82±26 s, P < 0.01 ),successful rate of slow pathway ablation was higher(61.5% vs 40.0%, P <0.01),and rate of unsustained atrioventricular block (AVB) was lower (2.6% vs 12.7%, P <0.05).There was no difference about various permanent AVB and recurrence rate between two groups.Its proved that APM is more safty and effective in treatment of AVNRT by RFCA.It would be well employed in RFCA of dual atrioventricular nodal pathway with junctional tachycardia.