三磷酸腺苷在射频消融治疗房室结折返性心动过速的应用价值

Clinical Value of Adenosine Triphosphate on Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia

目的:探讨三磷酸腺苷(ATP)在射频消融(RFCA)慢径治疗慢-快型房室结折返性心动过速(AVNRT)的应用价值。方法:40例慢-快型AVNRT患者经股静脉快速注射ATP,直至出现房室结双径路(DAVNP)现象及Ⅱ度或Ⅲ度房室传导阻滞。RFCA慢径阻断成功后重复原ATP剂量,连续记录体表心电图和心内电图。结果:29例(72.5%)行ATP注射者出现DAVNP,RFCA慢径阻断成功后均无DAVNP现象。结论:ATP可以作为诊断DAVNP的一个判定指标。

Objective To explore the clinical value of adnosine triphosphate（ATP） on radiofrequency catheter ablation（ RFCA） of slow-pathway of slow-fast type atrioventricular nodal reentrant tachycardia （ AVNRT）. Methods ATP was injected to 40 patients suffering from slow-fast AVNRT through a femoral vein until signs of DAVNP and second-or third-degree atri- oventricular block were observed. After successful slow pathway ablation, body surface and intracardiac Electrocardiogram at the dose of ATP required to achieve DAVNP was consecutively recorded. Results DAVNP was observed in 29 cases （72. 5% ） before RFCA,but after successful slow pathway ablation,there was no DAVNP in the 29 patients having ever had DAVNP by injecting repeated dose of ATP. Conclusions The result indicates that ATP may be useful for clinical diagnosis of DAVNP.