射频消融慢径路对不典型房室结双径路前传功能的影响

The effect of radiofrequency ablation on anterograde conduction in patie nts without obvious electrophysiological features of dual AV node pathway

目的:观察不典型房室结折返性心动过速(AVNRT)患者慢径路被消融后对快径路前传功能的影响。方法:38例成功行慢径射频消融的AVNRT患者,其中19例心房刺激均呈连续性AVNFC(甲组);对照组(乙组)19例心房刺激均呈跳跃性AVNFC。比较两组患者慢径射频消融前后的电生理参数变化。结果:消融后两组患者心房递增起搏时最大AH间期(A1H1max)均比消融前显著缩短,乙组A2H2max及ERPAVN-前传有明显变化,而甲组变化不大。结论:房室结双径路是彼此有相互关联的两条径路,与典型AVNRT一样,不典型AVNRT射频消融慢径路后前传功能得到改善。

Objective：To assess the changes of fast pathway anterograde conduction in patients with atrioventricular nodal reentrant tachycardia （AVNRT） after ablation of slow pathway, which is without the obviously electrophysiological features of dual AV node pathway, Methods： Thirty-eight patients with AVNRT, who had under gone ablation of slow pathway were divided into 2 groups. Group A（n= 19） ：patients with continuous atrioventricular nodal functional curves （AVNFC） . Group B（n= 19） ： patients with jumping AVNFC. Electrophysiological parameters were compared between two groups before and after ablation . Results ：A1Hlmax shortened obviously in two groups during atrial incremental pacing after ablation（P（0.05 or （0.01）. The A2H2/A3H3max and the effective refractory period of atrioventricular node （ERPAVN） were changed obviously in Group B（P〈0. 05 or 〈0. 01）,but there was no significant change in Group A after ablation （P〉 0. 05 ） . Conclusion： There is mutual associations between the fast and slow atrioventricular nodal pathways. The patients with jumping AVNFC or with continuous AVNFC have shown that ablation of slow pathway might improve the conduction of anterograde fast pathway.