射频消融房室结慢径对房室结折返性心动过速患者房室结传导功能的影响

Atroventricular nodal electrophysiological changes in patients with atroventricular nodal reentract tachycardia after slow pathway radiofrequency ablation

目的 探讨射频消融房室结慢径对房室结折返性心动过速患者房室结的传导功能影响及其与复发的关系。方法 2 8例确诊房室结双径路伴房室结折返性心动过速患者进行房室结慢径消融 ,术前术后分别测房室结文氏周期(Wen AVN) ,房室结快径有效不应期 (ERP FP)观察慢径消融对房室结传导功能的影响。结果 2 8例消融前后Wen AVN由 (373 5 7± 39 6 5 )ms缩短为 (336 4 3± 34 13)ms,差异有显著性 (P <0 0 5 ) ,ERP FP由 (32 6 79± 38 0 1)ms缩短至 (2 6 2 96± 4 2 6 9)ms,差异有显著性 (P <0 0 5 )。随访发现 2例复发 ,复发组均存在逆P。结论 慢径的消融改变了房室结的电生理功能 ,主要表现为快径的传导功能的改善 。

Objective To investigate atroventricular nodal electrophysiological changes and its relationship with recurrence of atroventricular nodal reentract tachycardia (AVNRT) after radiofrequency ablation of the slow pathway. Methods 28 patients with AVNRT were selectively ablated the slow pathway and compared the atroventricular nodal electrophysiological characteristics before and after ablation. Results All the patients were successfull in ablating AVNRT. Compared with pre ablation,Wen AVN decreased from (373 57±39 65) ms to (336 43±34 13) ms, ERP FP decreased from (326 79±38 01) ms to (262 96±42 69) ms(all P <0 05). Clinical recurrence of AVNRT was obserned in 2 patients who had P′. Conclusion Selective ablation of slow pathway improves the conduction of antegrate fast pathway. AVNRT may recurr if retrograde P waves persist.