房室结折返性心动过速(慢-快型)慢径不同消融终点与临床疗效关系研究

The study of the Relation between different endpoints of slow atrioventricular nodal pathway ablation and clinical efficiency in patients with atrioventricular nodal reentrant tachycardia(slow-fast kind)

目的:观察房室结折返性心动过速慢径不同消融终点与临床疗效关系。方法:慢-快型房室结折返性心动过速(AVNRT)350例,行慢径消融治疗,观察A型终点(阻断慢径且不再诱发AVNRT),B型终点(保留慢径且不能诱发AVNRT和心房回波)和C型终点(保留慢径且能诱发1～3个心房回波)对房室传导功能的影响及与AVNRT复发的关系。结果:(1)消融后A型终点77%(270例),B型终点16%(59例),C型终点7%(21例)。(2)消融后A型终点病人的房室传导功能明显改善,B、C型变化不明显。(3)A、B、C三型,平均随访(4±1.5)(0.5～8)年,复发率无明显差别。结论:A型终点病人阻断慢径后房室结传导功能明显改善,B、C型无明显改善,A、B、C型近,远期复率相同。

Objective：The study of the relation between different endpoints of slow atrioventrieular nodal pathway ablation and clinical efficiency in patients with atrioventricular nodal reentrant tachycardia. Methods：350 patients with atrioventricular nodal reentrant （AVNRT） were treated with slow atrioventricular nodal pathway ablation in order to observe the effect of endpoint type A （on slow pathway conduction and on inducible AVNRT）, B （residual slow pathway conduction but no inducible AVNRT and AVN echo ）and C （residual slow pathway conduction and 1-3 AVN echo but no induciable AVNRT）. Results： （1）endpoint A 77% （270 case）, endpoints B 16% （59 case）, endpoint C 7% （21 case）. （2）There was inpmvement of AV conduction in patients with endpoint type A, but no difference in patients with type B and C before and after slow pathway ablation. （3）All patients were followed up 4±1.5 （0.5 -8） years and AVNRT recurrence were same. Conclusion ：There was improvement of AV conduction in patients with endpoint type A,but no difference in patients with type B and C before and after slow pathway ablation. The recurrence rate of AVNRT was same in type A,type B and type C.