冠状窦口周围射频消融治疗房室结折返性心动过速

Radiofrequency ablation slow-way around the coronary sinus ostium to treat atrial ventricular nodal reentry tachycardia

目的依据房室结折返性心动过速（ＡＶＮＲＴ）患者冠状窦口向上扩张的研究结果，进一步探讨于冠状窦口 周围射频消融治疗ＡＶＮＲＴ的临床效果和安全性。方法对１５例ＡＶＮＲＴ患者在进行系统心内电生理检查后，进行 射频消融。此１５例病人靶点均选在冠状窦口附近，其中窦口上缘１２例，偏侧缘２例，近下缘１例。电位示小Ａ大 Ｖ，功率 １５～ ３０Ｗ，平均放电时间为（７２．０± １６．８）ｓ。结果 １２例一次放电成功，２例放电两次成功， １例三次就位放 电成功。其中９例出现交界性早搏，３例出现短暂交界性心律，３例无任何心律异常改变，无１例出现一过性或永久 性房室传导阻滞。随访３个月～１．５年均无心动过速复发。结论选择冠状窦口上缘行射频消融房室结慢径对 ＡＶＮＲＴ患者具有较佳的临床效果和较大的安全性。

Objective To discuss the clinical effect and security of radiofrequence catheter ablation around the ostium sinus coronary on those who suffered from atrial ventricular nodal reentry tachycardia(AVNRT). Methods Fifteen cases of AVNRT received radiofrequency ablation after the electrophysiological examination. The target point of all the cases were selected around the ostium sinus coronary, including 12 case at the upper rim, 2 cases at the side rim, 1 cases at the lower rim. The electrical potential showed small A and large V, the power was 15-30w, and the average discharge time was(72 ± 16. 8) s. Results Twelve cases succeeded at the first discharge, 2 cases at the second discharge, 1 case at the third discharge. Junctional premature beat was found in 9 cases, temporary junctional rhythm was found in 3 cases. No abnormal rhythm was found in other 3 cases. No temporary or persistent A-V block was found in any cases. No tachycardia recured after 3 month to 1 .5 years. Conclusion To the AVNRT cases, the ablation of the slow pathway at the upper rim of ostium sinus coronary takes better clinical effect and security.