射频消融术治疗阵发性室上性心动过速临床分析

Clinical analysis of supraventricular tachyeardia treated by catheter radiofrequency ablation

目的评价阵发性室上性心动过速（PSVT）患者射频消融的治疗效果及安全性。方法回顾分析300例经导管射频消融治疗的PsVT患者的治疗效果，其中房室结折返性心动过速（AVNRT）170例、房室旁道所致房室折返性心动过速（AVRT）130例。结果房室结双径路170例，其中房室结双径路慢快型169例，慢慢型1例。AVNRT中还包括合并房室旁道5例，合并右心室流出道室性心动过速（室速）和室性期前收缩（室早）2例，合并阵发性心房颤动1例，合并Koch三角房性心动过速（房速）1例；手术成功率100％，随访6个月到3年，复发3例，复发率1．8％。房室旁道130例，其中左侧旁道100例（左前游离壁旁道65例，左侧壁旁道28例，左侧双旁道1例，左后间隔旁道3例，左中间隔1例，左侧心外膜旁道2例），右侧旁道30例（右侧游离壁旁道18例，右后间隔旁道5例，右侧Mahaim旁道1例，右后间隔慢旁道2例，右后侧壁旁道2例，希氏束旁道2例）。手术成功率99．2％，随访6个月到3年，复发4例，复发率3．1％。发生心包积液1例。结论射频消融术是一种有效的根治室上性心动过速的方法，成功率高，并发症少。

Objective To assess the efficacy and the safety of supraventricular tachycardia（PSVT） treated by radiofrequency ablation. Methods All 300 cases of patients with PSVT were treated by catheter radiofrequency ablation, including 170 cases of atrioventricular nodal tachycardia and 130 cases of atrioventricular pathways. Results In 170 AVNRT patients, slow-fast type occurred in 169 patients and the other one was slow-slow type. Five patients acompanied by atrioventricular pathways; 2 patients had right ventricular outflow tract ventricular tachycardia and ventricular premature beat; one had paroxysmal atrial fibrillation; one had Kock triangle atrial tachycardia. The operation success rate was 100% with the recurrence rate of 1.8% （3/169）. 130 cases of AVRT patients included 100 cases of left accessory pathway and 30 cases of right accessory pathway. The operation success rate was 99.2% with the recurrence rate of 3.1% （4/129）. Conclusions The results show that the treatment of PSVT by catheter radiofrequency ablation is curative, effective and safe. The complication is minor.