导管射频消融房室结折返性心动过速临床分析

Clinical analysis of radiofrequency catheter ablation in patients with atrioventricular nodal reentrant tachycardia

目的 探讨射频消融术治疗房室结折返性心动过速实用、有效的方法。方法 38例房室结折返心动过速 (AVNRT)患者 ,采用下位法或后位法消融慢径 ,观察其成功率及并发症。结果 38例患者消融时 ,采用下位法 30例、后位法 8例 ,消融慢径首次成功 35例 ,成功率为 92 .10 % (35 / 38) ,行两次消融后 ,总成功率 97.36 %(37/ 38)。术中 3例出现一过性 °～ °房室传导阻滞 (AVB)。随访 4～ 70月 ,3例复发 ,复发率为 7.89%。结论 RFCA治疗 AVNRT是安全、有效的方法 ,成功的最重要因素包括导管操作者经验。

Objective To explore a practical and effective radiofrequency catheter ablation(RFCA) procedure in treatment of atrioventricular nodal reentrant tachycardia(AVNRT).Methods Slow pathway ablation was performed by inferior method or posterior method in 38 patients with AVNRT and the success rate as well as complications were studied after RFCA.Results Thirty cases were treated by using inferior anatomic technique and 8 cases using posterior anatomic technique.The success rate was 92.1%(35/38) by RFCA in the first time.After second ablation,the overall success rate was 97.36%(37/38).During the ablation procedure,there were 3 patients complicated with Ⅱ°～Ⅲ° transient atrioventricular block(AVB).In 4～70 months follow up observation,recurrences were found in 3 cases,the recurrence rate was 7.89%.Conclusion RFCA is a safe and effective method in treating patients with AVNRT.The main factors determining the success rate of RFCA were the experience of opereter,the recognition of the target electogram and correct determination of ablation endpoints of RFCA.