射频消融术治疗快速心律失常临床疗效分析

The Radiofrequency Catheter Ablation of Tachyarrhythmia:Retrospective Analysis of 232 Cases

目的通过对射频消融术(RFCA)治疗快速心律失常的结果进行分析,以总结RFCA的治疗效果和安全性。方法对心血管内科近3年232例快速心律失常患者(包括阵发性室上速、室早、室速、房速、房扑和房颤)的射频消融方法、成功率、复发率及并发症等进行回顾性分析。结果平均随访6～30个月,232例患者中227例RFCA治疗成功,一次治疗成功率达97.8%,复发率为2.16%(5/232),严重并发症发生率为0.87%(2/232),其中1例发生心包填塞,1例出现Ⅱ度房室传导阻滞。结论 RFCA治疗快速心律失常安全、有效、成功率高、并发症发生率低。精确的定位、仔细熟练的操作以及严格控制消融的能量和时间,能有效地提高治疗成功率、明显降低手术并发症。

Objective To summarize the efficacy and security of radiofrequency catheter ablation （RFCA） for the treatment of tachyarrhythmia. Methods The methods, successful and recurrence rate and clinical complication of radiofrequency catheter ablation（RFCA） for the treatment of 232 patients with tachyarrhythmia（ including Paroxysmal supraventricular tachycardia, premature ventriculars, ventricular tachycardia, Atrial tachycardia, Atrial flutter and Atrial fibrillation） were analyzed retrospectively. Results Two hundred and twenty-seven patients with tachyarrhythmia radiofrequency catheter ablation were cured by RFCA procedures. The total successful rate was 97.8%. During a mean follow-up of 6 - 30 months, the recurrence rate of ablating tachyarrhythmia was 2.16% （5/232） , the rate of serious clinical complication was 0.87 % （2/232） , including one patient with pericardial effusion and one with permanent II atrioventricular block（AVB）. Conclusion RFCA for the treatment of tachyarrhythmia was effective and safe. Accurate mappifig, careful and skillful manipulating, and strict control of energy and time during ablation can improve success rate, and decrease the complication in large extent.