经导管射频消融治疗室上性心动过速复发原因分析

Analysis of Recurrence of Paroxysmal Supraventricular Tachycardia after Radiofrequency Catheter Ablation

目的：分析总结经导管射频消融（RFCA）治疗阵发性室上性心动过速（PSVT）术后复发的原因，以进一步指导临床工作。方法：对1992年2月～2008年6月我院实施RFCA治疗的1256例PSVT术后随访资料进行回顾分析。每3个月随访1次，随访期3个月～16年，统计复发例数，分析复发原因。结果：1256例首次行RFCA成功1227例，一次成功率97．7％；术后复发29例，复发率2．3％。743例房室折返性心动过速（AVRT）中复发18例，复发率2．4％，其中左侧旁道复发10例（1．7％），右侧旁道复发8例（4．9％）；513例房室结折返性心动过速（AVNRT）中复发11例，复发率2．1％。结论：RFCA治疗快速性心律失常安全、有效、成功率高。精确的靶点标测、熟练的操作技巧以及正确运用消融方式是降低RFCA术后复发率的关键。

Objective：To analyze the factors of recurrence of paroxysmal supraventricular taehycardia（PSVT） after radiofrequency catheter ablation （RFCA） in order to reduce the recurrence rate and provide guidelines for further clinical work. Methods ： 1 256 patients with PSVT admitted into our hospital during Feb. 1992-June 2008 were followed up for from 3 months to 16 years,once every 3 months and their electrophysiological data were retrospectively analyzed. Results： Of the 1 256 patients, 1 227 had successful RFCA with a success rate of 97.7% and recurrence rate at 2.3% （29 cases）. There were 743 cases of atrioventrieular reentrant tachycardia （AVRT）and 513 cases of atrioventricular nodal reentrant taehycardia （AVNRT）. The recurrence rate was 2.4% （18 cases）in patients with AVRT, 1.7% （10 cases）in patients with left AP and 4.9% （8 cases）in patients with right AP, and 2.1% （ 11 cases） in patients with AVNRT. Conclusion：RFCA can be performed effectively and safely in patients with PSVT. Accurate targeting, full mastery of the technique and methods of RFCA are the key factors to reduce the recurrence rate.