张丽娜, 刘雄涛, 王毅, 李军, 郑强荪. 房室结折返性心动过速慢径消融终点与复发的关系[J]. 心脏杂志, 2010, 22(6): 878-880.
    引用本文: 张丽娜, 刘雄涛, 王毅, 李军, 郑强荪. 房室结折返性心动过速慢径消融终点与复发的关系[J]. 心脏杂志, 2010, 22(6): 878-880.
    Study of endpoints of slow atrioventricular nodal pathway ablation in patients with atrioventricular nodal reentrant tachycardia[J]. Chinese Heart Journal, 2010, 22(6): 878-880.
    Citation: Study of endpoints of slow atrioventricular nodal pathway ablation in patients with atrioventricular nodal reentrant tachycardia[J]. Chinese Heart Journal, 2010, 22(6): 878-880.

    房室结折返性心动过速慢径消融终点与复发的关系

    Study of endpoints of slow atrioventricular nodal pathway ablation in patients with atrioventricular nodal reentrant tachycardia

    • 摘要: 目的: 观察房室结折返性心动过速(AVNRT)的慢径消融终点与复发的联系。方法: 534个慢-快型AVNRT患者行慢径消融治疗,观察A型终点(彻底消融慢径,房室结无跳无折)和B型终点(残留慢径有或无1~3心房回波,不能诱发AVNRT)与AVNRT复发的联系及对房室结传导的影响。结果: ①A型复发5例(1.2%),B型复发11例(9.4%),差异有统计学意义(P<0.05)。②A型终点房室结前传文氏周期(Wen-AVN)、快径前传有效不应期和房室结双径路(DAVNP)的跳跃增值缩短,B型快径前传有效不应期和房室结双径路的跳跃增值缩短,A型有效不应期的缩短明显大于B型。结论: A型终点的复发率明显低于B型终点;只要改变房室传导功能,不能诱发心动过速,B型终点仍然是有效、可靠的消融终点。

       

      Abstract: AIM: To study the relationship between endpoints of slow atrioventricular nodal pathway ablation and recurrence in patients with atrioventricular nodal reentrant tachycardia (AVNRT). METHODS: Slow pathway radiofrequency ablation was performed in 534 patients with slow-fast AVNRT and the effect of endpoint was observed in type A (complete disappearance of slow pathways and inducible AVNRT with no jumping phenomenon and AVN echo) and type B (residual slow pathway conduction without inducible AVNRT). RESULTS: Endpoint A recurred in 5/415 cases (1.2%) and endpoint B recurred in 11/117 cases (9.4%) with significant differences between them. AV1∶1CL, FP-ERP and △A2H2 of endpoint A became shorter and FP-ERP and △A2H2 of endpoint B became shorter, but △FP-ERP of endpoint A was longer than endpoint B. CONCLUSION: The recurrence rate of type A is lower than that of type B. Type B can be an effective and safe ablation endpoint with good AV conduction and no inducible AVNRT.

       

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