房室结改良术终点、快径传导功能与 复发率三者关系的回顾性研究

Retrospective study of correlation among ends of radiofreqency atrioventricular node modification conduction function of fast path way and recurrence rate

探讨射频消融（ｒａｄｉｏｆｒｅｑｅｎｃｙ ｃａｔｈｅｔｅｒ ａｂｌａｔｉｏｎ， ＲＦＣＡ）房室结慢径终点、快径前向传导功能与心动 过速复发率的关系。方法：对７６例经系统电生理检查、ＲＦＣＡ证实为房室结折返性心动过速（ａｔｒｉｏｖｅｎｔｒｉｃｕｌａｒ ｔａｃｈｙ－ ｃａｒｄｉａ，ＡＶＮＲＴ）的患者根据消融终点分为三组：①Ａ组，为４４例慢径消融后慢径完全消失病人；②Ｂ组，为１７例慢 径消融后慢径尚残存，但无心房回波病人；③Ｃ组，为１５例慢径消融后慢径残存且有心房回波病人。对以上三组 病人进行回顾性研究，探讨慢径消融终点、房室结快径传导功能及复发率三者关系。结果：①Ａ组和Ｂ组，慢径 消融后其快径前传功能不应期和有效不应期明显缩短，随访期间无心动过速发作；②Ｃ组，慢径消融后其快径前 传功能不应期和有效不应期缩短不明显，随访期间有５例复发心动过速。结论：房室结双径路是彼此关联的两 条径路，功能慢径的存在可能在一定程度上抑制快径的传导功能；ＡＶＮＲＴ慢径消融最好达到慢径消失，若慢径残 存，亦应消融到无心房回波和快径传导功能明显改善。

Study the correlation among radiofreqency catheter ablation (RFCA) ends Of slow Pathway Of atrioventricular node、forward conduction function of fast pathway and recurrence rate of tachycardia. Methods: 76 patients, who had been identified with atrioventricular tachycardia (AVNRT) by systemic electrophysiological examination and RFCA, were classified as three groups:①A group were 44 patients,whose slow pathways completely disappeared after atrioventricular node modificagtion; ②B group were 17 patients, whose slow pathways were still remained, but no atrial echo; ③C group were 15 patients, who had slow pathway and atrial echo. Retrospectively studied all the three groups patients, and explored the ends of slow pathway ablation, conduction function of atrioventricular node fast pathway and recurrence rate. Results: ①A and B groups, function refractory period and effective refractory period obviously shortened after slow pathway ablation, no tachycardia reoc- curred while following up; ②C group, function refractory period and effective refractory period not obviously shortened after slow pathway ablation, tachycardia for 5 patients while following up. Conclusion: Dual atrioventricular node pathways are two pathways related each other and slow pathway probablely inhibit the conduction function of fast pathway; AVNRT modification should have the end without slow pathway, if slow pathway were remained, the modification should have the end without atrial echos or conduction function of fast pathway obviously improved.