射频消融术治疗房室结折返性心动过速483例临床分析

Treatment of atrioventricular nodal reentrant tachycardia with radiofrequency ablation: report of 483 cases

目的观察射频消融术治疗房室结折返性心动过速(AVNRT)的疗效及安全性。方法对483例行射频消融术治疗的AVNRT患者的临床资料进行回顾性分析。所有病例均经心内电生理检查,明确诊断AVN-RT后,再分为慢快型、快慢型、慢慢型三型,以中下位法结合电解剖法行射频消融术,统计总的和3组的消融成功率、并发症发生率、病死率、复发率等。结果射频消融术治疗AVNRT总的成功率99.4%,并发症发生率2.28%,复发率1.45%,无死亡病例。慢快型、慢慢型、快慢型三型一次成功率差异无统计学意义,快慢型、慢慢型较慢快型并发症发生率、复发率为高,差异有统计学意义。结论射频消融术治疗AVNRT总的成功率高,并发症少,复发率低。但快慢型、慢慢型较慢快型并发症发生率、复发率为高,须引起足够重视。

Objective To evaluate the efficacy and safety of radiofrequency ablation in treatment of atrioventrieular nodal reentrant taehycardia （AVNRT）. Methods Retrospective analysis was carried out on 483 electrophysiologieally proven AVNRT patients, who were divided into 3 groups： Group A （slow -fast type）, Group B （fast -slow type） and Group C （slow- slow type）. Radiofrequency ablation was performed on each patient. The success rate, recurrence rate, and incidence rates of complication and mortality were recorded. Results The success rate, recurrence rate and incidence of complication were 99.4%, 1.45% and 2. 28% , respectively. Furthermore, no death was recorded. No significant difference was observed in success rate among the 3 groups, while significant higher complication incidences and recurrence rates were revealed in Group B and C than those in Group A （P 〈 0. 05）. Conclusion Radiofrequency ablation for AVNRT treatment provides high success rate with low incidence of complications and relapses. However, the relatively higher complication and recurrence rates in fast - slow type and slow - slow type AVNRT should be emphasized.