经导管射频消融术对心脏和心脏自主神经的急性期损伤

Acute Injury of Radiofrequency Catheter Ablation to the Heart and Autonomic Nerves

目的 为探讨经导管射频消融术对心脏和心脏自主神经的急性期损伤.方法 选择接受射频消融术的阵发性室上性心动过速病人120例,在术前、术后进行超氧化物歧化酶测定和心率变异性分析.结果 射频消融术后超氧化物歧化酶较术前明显增高(P<0.01);术后心率变异性的各项频域和时域指标均降低,但与超氧化物歧化酶变化无明显相关.结论 射频消融术对心脏和心脏自主神经的急性期损伤是存在的,但术后心率变异性的降低是由于射频电流损伤心脏迷走神经所致,与手术引起的心肌应激性损伤无关.

ObjectiveTo study the acute injury of Radiofrequency Catheter Ablation (RFCA) to the heart and it's autonomic nerves. MethodsSuperoxide Dismutase(SOD) and Heart Rate Variation(HRV) were measured in 120 cases with paroxysmal supraventricular tachycardia (PSVT) pre and post RFCA. ResultsSOD post RFCA increased obviously than that of pre-operation(881.68±328.16) vs (319.77±176.34)ng/mL, P<0.01). HRV includes Very Low Frequency (VLF), Low Frequency(LF), High frequency(HF), R-R interval, root mean standard deviation of successive (rMSSD)and the percentage of NN interval deviation were greater than 50ms (PNN50). Changes were significant between pre and post RFCA operation(P<0.05,<0.01,<0.01,<0.05,<0.05, irrespectively).But HRV changes were not evidently related to pre and post RFCA operation with SOD change .ConclusionRFCA operation can cause injury to the heart and it's autonomic nerves. HRV decrement post RFCA was resulted from acute injury of Cardiac vagus by radiofrequency current but not resulted from injury of myocardium. 