阵发性室上速射频消融失败分析

Analysis of the failure of radiofrequency catheter ablation in paroxysmal supraventricular tachycardia

目的探讨射频消融术治疗阵发性室上性心动过速失败的原因。方法回顾性分析1026例采用射频消融术治疗阵发性室上性心动过速患者的治疗结果。结果 1026例患者中,991例首次射频消融治疗成功,成功率96.6%。失败35例,其中左侧旁道13例,右侧旁道13例,房室结双径路9例,19例再次行消融治疗获得成功,总成功率98.4%(1010/1026)。结论初学者消融失败原因主要为导管操作不熟练和诊断不够明确,熟练者主要因解剖结构异常导致导管操作困难和靶点图识别不准确。

Objective To explore the reasons for the failure of radiofrequency catheter ablation（RFCA） in paroxysmal supraventricular tachycardia（PSVT）.Methods The clinical efficacy of RFCA for 1026 patients with PSVT was retrospectively analyzed.Results Of 1026 patients with PSVT,991 cases（96.6%） successfully underwent RFCA operation for the first time.There were 35 unsuccessful cases,including 13 left accessory pathways,13 right accessory pathways and 9 cases of atrioventricular nodal reentrant tachycardia（AVNRT）,but 19 patients were cured undergoing re-ablation,the total success rate of ablation PSVT was 98.4%（1010/1026）.Conclusions For the beginners,the main reasons for the failure of RFCA were the unskilled catheter operation and undetermined diagnosis.For the technical experts,the main reasons were anatomical abnormalities leading to difficult catheter operation and inaccuracy of targeted electrogram.