经房室慢旁道逆传的室上性心动过速的电生理表现及射频消融治疗

Electrophysiologic Characteristics and Radiofrequency Catheter Ablation of Supraventricular Tachycardias with Decremental Accessory Pathways

目的探讨房室慢旁道的电生理特点及导管射频消融的疗效。方法回顾性分析7例经房室慢旁道逆传的室上性心动过速患者的心脏电生理检查及射频消融的临床资料。结果 7例患者电生理检查显示慢旁道只有逆传功能,呈递减性质并伴有文氏现象,心动过速时RP’>P’R,准确标测慢旁道宜在心动过速时进行,成功靶点应记录最早的逆向A波,但VA不融合,其间存在等电位线。首次消融术后只有1例复发,再次消融成功后随访无复发,所有病例均无并发症发生。结论房室慢旁道具有特殊的电生理特性,射频消融是安全有效的根治方法。

Objective To explore the electrophysiologic characteristics of decremental accessory pathways and efficacy of radiofrequency catheter ablation（RFCA）.Method Clinical data of 7 cases with decremental accessory pathways were retrospecively analysed.Results The electorcardiogram in all 7 patients show RP’ P’R during tachycardia.Retrogarde conduction in pathway exhibited decrementa] conduction.The long and separate V A time can be recorded at target site of pathway successful ablationed.The site of earliest reverse A wave in tachycardia is just the target.Conclusion The decremental accessory pathways have special electrophysiologic chatacter.RFCAis an effective and curative therapy for supraventricular tachycardias with decremental accessory pathways.