房室结双径路慢径消融时连续AV非1∶1比例与短暂房室传导阻滞的相关性

The study of the relationship between atrioventricular block and continuous AV non 1∶1 proportion during radiofrequency ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia.

目的分析房室结双径路导管射频消融时出现连续AV非1∶1比例与房室传导阻滞(AVB)发生的相关性及放电导致AVB的特点,为消融时预防AVB提供思路与方法。方法回顾113例房室结双径路的导管消融电生理资料,分析放电时AV的比例、波幅比值及患者性别、年龄等因素与出现AVB的相关性。结果放电时出现连续AV非1∶1比例时,短暂AVB的发生率显著高于无AV非1∶1比例者(36.84%vs 0.52%,P<0.05)。靶点腔内心电图呈小A大V,A波较宽、碎裂,不带有H波,在此基础上放电是否出现AVB与AV波幅比值无关(P>0.05)。女性AVB的发生率高于男性(34.78%vs 6.82%,P<0.05)。随访中未见AVB发生及室上性心动过速复发。结论放电时出现连续AV非1∶1比例可能发生AVB,须立即停止放电;女性患者更易出现AVB。

Objective To analyze the correlation between atrioventricular block （AVB） and continuous AV non 1：1 proportion during the radiofrequency catheter ablation （ RFCA ） procedures in patients with atrioventricular nodal reentrant tachycardia （AVNRT） and the characteristics of AVB in order to provide a method to prevent AVB from the RFCA of AVN- RT. Method Cardiac electrophysiology data of 113 consecutive patients were analyzed retrospectively. The relationship between AVB and clinical data, proportion of AV numbers and proportion of AV amplitude during the radiofrequency abla- tion was analyzed. Results The transient AVB occurred in 21 patients （36.84%） when the continuous AV non 1 ： 1 proportion appeared, and the incidence of AVB was 0.52% when there was no continuous AV non 1：1 proportion during the radiofrequency current delivering, as for as the incidence of AVB, there was a significant differences between the two groups with or without continuous AV non 1：1 proportion （P 〈 0.05 ）. And there was not significant difficences in the relationship between the ratio of AVB and proportion of AV amplitude （P 〉 0.05）. The ratio of AVB was higher in females than that in males（34.78% vs 6.82% ,P 〈 0.05 ）. There was no AVB occurred and AVNRT recurred in the follow-up period. Con- clusion The radiofrequency should be immediately discontinued when the continuous AV non 1：1 proportion does occurr during energy delivering in RFCA for the AVB might occurred, and females present a higher percentages of AVB than males do. [ Chinese Journal of Cardiac Pacing and Electrophysiology, 2008,22 （ 5 ） ： 396 - 399 ]