射频导管消融治疗96例快速心律失常

RADIOFREQUENCY CATHETER ABLATION OF TACHYARRHYTHMIA IN 96 PATIENTS

目的：小结射频导管消融治疗９６例快速心律失常的经验。方法：对９６例快速心律失常行射频消融治疗，其中房室旁道５１例５３条、房室结双径路２３例、室性心动过速１６例、房性心动过速４例、心房扑动２例。消融前常规行电生理检查，以确定心律失常的类型和解剖部位。结果：全组首次消融成功率为９２６％，其中左侧房室旁道为１００％，左室室性心动过速为８５７％，右室室性心动过速为５５６％，房性心动过速为７５％，心房扑动为１００％。消融术后房室折返性心动过速复发率为３４％，二次消融成功率为１００％。本组无严重并发症发生。结论：射频导管消融是治疗某些快速心律失常的一种安全和有效的根治方法。

Objective:To describe our initial results of catheter ablative therapy for tachyarrhythmia in the first 96 consecutive patients in our department.Methods:Ninetyfive patients with symptomatic tachyarrhythmia involving accessory AV connections in 51,atrioventricular nodal dural pathway(AVNDP) in 23,ventricular tachycardia in 16,atrial tachycardia in four and atrial flutters in two underwent catheter ablation with the use of radiofrequency current.Before the ablation,routine electrophysiological tests were performed to differentiate and localize the arrhythmogenic substrate.Results:Successful initial ablations were archived in 926% of all patients,in 100% of left accessory pathway,in 947% of right pathways,in 100% of AVNDP,in 857% of left ventricular tachycardia,in 556% of right ventricular tachycardia,in 75% of atrial tachycardia and 100% of atrial flutter.Tachycardia recurred in three patients(34%) of accessory AV connection after a ablation procedure,but second ablation was successful in them.A nonfatal complication occurred in one patient.Conclusion:Radiofrequency catheter ablative therapy is a safe and curative modality for certain tachyarrhymia.