702例房室结折返性心动过速的射频消融治疗

Clinical analysis of radiofrequency ablation in 702 patients with dual atrioventricular nodal pathways

目的回顾性总结射频消融术治疗702例慢快型房室结折返性心动过速(AVNRT)的疗效及安全性。方法所有病例均先行心内电生理检查,明确诊断后,以中、下位法行射频消融,结合影像学和腔内电图确定靶点。结果本组射频消融成功率99.6%,复发率1.0%,并发症发生率1.3%,无死亡病例。结论射频消融治疗AVNRT成功率高,并发症少,复发率低,以中位法消融、延长单次有效放电时间、消融后房室结不应期延长且达到慢径消失,可有效提高AVNRT的消融成功率,且明显降低术后复发率,寻找有效靶点,细致操作能有效预防并发症发生,心房起搏有一定价值。

Objective To retrospectively sum up the efficacy and safety of radiofrequency ablation in patients with dual atrioventricular nodal pathways. Methods The slow pathways were ablated in 702 patients with dual atrioventricular nodal pathways, some parameters were studied. Results The successful rate was 99.6%, and the complication rate was 1.3 %, and the recurrence rate was 1.0%. There was no death. Conclusion Slow pathway ablation in patients with dual atrioventricular nodal pathways has high successful rate, low complication rate and recurrence rate. To increase the successful rate and lower the recurrence rate, methods were used such as ablation at medium position, prolongation of single ablation time, disappearance of slow pathways. Atrial pacing is of some value to the ablation.