射频消融术治疗阵发性室上性心动过速382例临床分析

目的评估经导管射频消融术(RFCA)治疗阵发性室上性心动过速的临床疗效。方法对心内科近两年382例伴不同阵发性室上性心动过速的患者采用射频消融治疗,对治疗结果进行回顾性分析,比较左侧旁道、右侧旁道及房室结双径路伴阵发性室上性心动过速患者术后成功率、复发率及并发症发生率等临床数据的差异。结果房室折返性心动过速患者174例,其中左侧旁道113例,右侧旁道61例;房室结折返性心动过速208例。射频消融总成功率为97.4%,其中房室结双径路和左侧房室旁道介导的阵发性室上速射频消融成功率达98.4%。射频消融术后总复发率为2.6%,并发症发生率为1.8%。结论射频消融治疗快速室上性心律失常安全、有效,成功率高,并发症发生率低。右侧旁道消融复发率高于左侧旁道及双径路。

普罗帕酮与维拉帕米转复阵发性室上性心动过速疗效对比研究

目的对比普罗帕酮和维拉帕米对阵发性室上性心动过速（PSVT）的治疗效果及各自的副反应。方法对我院急诊接诊的48例阵发性室上速随机分成普罗帕酮治疗组和维拉帕米治疗组，普罗帕酮组给予普罗帕酮70～140mg静注，维拉帕米组给予维拉帕米5～10mg静注。结果普罗帕酮和维拉帕米对阵发性室上性的治疗效果比较差异无统计学意义（P〉0．05），副作用维拉帕米较普罗帕酮高。结论PSVT应首选普罗帕酮，维拉帕米可作为一线药物，但须注意其副作用。

Radiofrequency Cathter Ablation for the treatment of 53 patients with paroxysmal supraventricular tachycardia

Radlofrequency Cathter Ablation was performed On 53 patientswith paroxysmal supraventrlcuinr tnchycnrdlm and gained fsfactory results.53 patients:male 32,female 20,aged about 44.4±13.18(21～70)yearn.All thepatients bad suprnventrlcuJar tachyeardla oceurrlng blatorles of more than 1year.Electrophyaiologte tests rhowed:18 with left-alded tecessory pathwayand 12 with concealed pathway,about 30 passways oll together in the left;4casea with right accessory pathway and I with eoncealed pathway,5 passwaysin the right;18 patients with atrioventrlenlar nodal dual pathway.EVA or EAAon A-V ring was the target picture In sceessory passwry sbletion.Middle orInferlor position was taken A-V nodal dual pathway ablation,with imall Alarge V as inrget pteture Includlng breaking up of wave A.The appenranceof slow A-V boarded rhythm daring electric ejection was marked as effectiveablation.Suprtventrlcular tachycardin cin’t be Initiated by various stimulateswas regarded as our final afm.All these patients got suceessful ablation.2cases recurred during foUow-up of 30±12 monthe,but cured after aecondablatlon.One of the recurrers bad right-position heart with atrfoventricularaccessory passway.The trigger site was detacted 3.5cm distance fromcoronary and ablated Juceessfully.

阵发性室上速射频消融术后复发原因分析

目的分析阵发性室上速射频消融术后复发原因,探讨消融技巧。方法分析394例阵发性室上速经射频消融治疗后心动过速复发与室上速分型的关系及近年操作技术的改进对消融复发率影响。结果旁道复发率为8%,其中右侧旁道复发率11.3%,左侧旁道复发率4.5%;双径路复发率5.2%。2005年前和2005年后相比,右侧旁道复发率分别为18.4%和4.8%;左侧旁道复发率分别为5.1%和4.2%;双径路分别为复发率7.3%和3.6%。结论阵发性室上速射频消融术后复发以右侧旁道多见(P<0.05);2005年后随着经验积累和操作技术改进,室上速射频消融术后复发率明显降低。