结区反应的类型和房室结折返性心动过速消融结果的相关性分析

The Assessment of Accelerated Junctional Rhythm Type on Efficacy of Radiofrequency Ablation of the Slow Pathway in Patients with Atrioventricular Nodal Reentrant Tachycardia

目的:分析在房室结折返性心动过速(AVNRT)的选择性慢径消融时出现的结区反应的类型与消融结果的相关性。方法:将200例AVNRT病人按选择性慢径消融后心动过速的复发与否分为消融成功组(共189例)及心动过速复发组(11例)。将在慢径消融过程中出现的结区反应按其特点分为Ⅰ型(放电后出现持续的结区反应,停止放电后即刻或间隔数秒恢复窦性心律)和Ⅱ型(放电后出现间歇性结区反应即窦性心律与结区心律交替出现,停止放电后可迅速恢复窦性心律)。结果:结区反应的类型成功组多为Ⅱ型,复发组多为Ⅰ型,结区反应出现的时间成功组较早,复发组较晚,两者间差别有统计学意义(5.09s±0.54s和7.82s±1.08s,t=-7.1,P<0.001)。结论:在AVN-RT病人的慢径消融过程中,结区反应的类型对靶点的选择具有重要指导意义。Ⅱ型结区反应可作为选择性慢径消融的有效靶点标志。

Objective： To assess an association between the accelerated junctional rhythm （AJR） type and the catheter ablation for atrioventricular nodal reentrant tachycardia （AVNRT）. Methods： The data of 200 eligible patients with AVNRT （ men69 ,womenl31 ,mean aged 48. lyears ：t： 12.5years） who had undergone the treatment of radiofrequeney ablation between Jan. 1998 and Dec. 2008 was reviewed. All participants were divided into the suecessful ablation group （n = 189） and the recurrence group （n = 11 ） according to the A JR type, if continuous AJR persisted until the end of energy delivery, type I A JR was defined, if intermit A JR alternated with sinus rhythm slow pathway ablation and was eliminated immediately when energy delivery stops, type II ＆JR was defined. Results ：The type II _AJR present is more in the successful ablation group, more the type I ＆JR is in the recurrence group. And the ＆JR responses of successful ablation group started relatively earlier than that of the recurrence group（5.09s±0.54s vs 7.82s ± 1.08s,P 〈0.001 ）. Concluslons：Type II AJR may be used as marker of successful slow pathway ablation target site and it is an important selection in patients with AVNRT during radiofrequency eatheter ablation.