右侧显性旁道顺、逆向标测方法定位消融靶点的对比研究

Comparison of the orthodromic method with the antidromic maping method for locating target of ablating overt right accessory atrioventricular pathway

目的 比较显性右侧房室旁道 (RAP)顺、逆向标测方法寻找导管法射频消融靶点的效果。方法 在显性RAP患者 10 0例中 ,电生理检查显示显性RAP 10 0条 ,5 1条采用顺向房室 (AV)标测法、49条采用逆向室房 (VA)标测法寻找消融靶点。结果 两种标测方法消融的成功率相同 (10 0 % ) ,但逆向标测方法标测和消融的总时间、试消融次数及复发率与顺向标测法相比 ,分别为 86± 13VS 12 5± 19min(P <0 0 1)、7± 5VS 15± 9(P <0 0 1)和 8 2 %VS 15 7% (P <0 0 1) ,差异非常显著。结论 导管法射频消融RAP ,即使旁道为显性 。

Objective To compare the effects of the orthodromic and the antidromic mapping methods in location target of the catheter radiofrequency ablation of overt right accessory atrioventricular pathway(RAP) Methods Among 100 overt RAPs in 100 patients determined by electrophysiological examination,the orthodromic atrioventricular(AV)mapping method,namely locating the shortest AV interval in 51 APs and the antidromic ventriculoatrial(VA)mapping method,namely locating the shortest VA interval in 49 APs were respectively used for locating the ablation target Results The succesful rates of the ablation of the both mapping methods were the same(100%),but the total time(min)of the mapping and the ablation,the times of attemptably ablating and the recurrent rate in the antidromic mapping group were 86±13 VS 125±19( P <0 01),7±5 VS 15±9( P <0 01)and 8 2% VS 15 7%( P <0 01) as compared with the orthodromic mapping group respectively Conclusion the mapping method of the ablating target for RAP shoud firstly select the antidromic mapping method even though RAP is overt