射频导管消融治疗不同分型房室结折返性心动过速患者的效果研究

Effect of radiofrequency catheter ablation in patients with different types of atrioventricular nodal reentrant tachycardia

目的探讨射频导管消融治疗不同分型房室结折返性心动过速患者的效果。方法选取2018年11月至2020年6月本院收治的104例房室结折返性心动过速患者作为研究对象,其中69例为慢快型设为典型组,10例快慢型及25例慢慢型设为不典型组。所有患者均在心房起搏下或窦性心律下行射频导管消融术治疗,比较不同分型心动过速患者发作时电生理指标及两组操作时间、消融成功率及复发率。结果慢快型患者AH间期长于快慢型及慢慢型患者,HA间期短于快慢型及慢慢型患者,且慢慢型患者AH间期长于快慢型患者,HA间期短于快慢型患者,差异有统计学意义(P<0.05);不同分型患者心动过速周长比较差异无统计学意义。两组操作时间、消融成功率比较差异无统计学意义;典型组复发率明显低于不典型组,差异有统计学意义(P<0.05)。两组均未发生严重并发症。结论射频导管消融治疗不同分型房室结折返性心动过速效果显著,但与典型房室结折返性心动过速患者相比,不典型房室结折返性心动过速患者的射频消融术后复发风险更高。

Objective To investigate the effect of radiofrequency catheter ablation in patients with different types of atrioventricular nodal reentrant tachycardia.Methods 104 patients with atrioventricular nodal reentrant tachycardia admitted to our hospital from November 2018 to June 2020 were selected as the study subjects,among them,69 patients with slow-fast type were set as the typical group,10 patients with fast-slow type and 25 patients with slow-slow type were set as the atypical group.All patients were treated with radiofrequency catheter ablation under atrial pacing or sinus rhythm,the electrophysiological indicators of patients with different types of tachycardia,and operation time,ablation success rate and recurrence rate between the two groups were compared.Results The AH interval of patients with slow-fast type is longer than that of fast-slow type and slow-slow type patients,the HA interval is shorter than that of fast-slow type and slow-slow type patients,and the AH interval of slow-slow type patients is longer than that of fast-slow type patients,the HA interval was shorter than that of the fast-slow type patients,and the difference was statistically significant(P<0.05);there was no significant difference in the tachycardia circumference of patients with different types.There was no significant difference in operation time and the ablation success rate between the two groups;the recurrence rate of the typical group was significantly lower than that of the atypical group,and the difference was statistically significant(P<0.05).There were no serious complications in the two groups.Conclusion Radiofrequency catheter ablation has significant effect on the treatment of different types of atrioventricular nodal reentrant tachycardia,but compared with patients with typical atrioventricular nodal reentrant tachycardia,patients with atypical atrioventricular nodal reentrant tachycardia have higher risk of recurrence after radiofrequency ablation.