摘要
【目的】探讨房室结折返和房室折返性心动过速(AVNRT,AVRT)的特点及射频消融(RFCA)的疗效和安全性。【方法】回顾性分析本院近6年行RFCA的823例AVNRT和AVRT患者的临床和电生理特点及手术情况。【结果】AVRT较AVNRT多见,AVNRT女性多于男性,而AVRT男性多见(P<0.01)。AVRT中左侧较右侧旁路多见,左侧旁路以隐匿性为主,而右侧旁路以显性为主(P<0.01);左侧旁路男性多见,而右侧旁路以女性为主(P<0.01)。右侧显性旁路手术成功率明显低于其他旁路和AVNRT(P<0.05和P<0.01),术后复发率明显高于左侧旁路(P<0.05和P<0.01)。2例AVNRT术后出现房室传导阻滞而植入心脏起搏器,发生气胸和血气胸6例,心包填塞1例,假性动脉瘤3例,1例左侧旁路放电时出现心室纤颤,无一例患者死亡。【结论】AVNRT和AVRT消融手术成功率高而复发率低,严重并发症较少,RF-CA治疗AVNRT和AVRT是有效和安全的。
[Objective]To evaluate the characteristics of atrioventricular node reentrant tachycardia（AVNRT） and atrioventricular reentrant taehycardia（AVRT） and the effects and safety of radiofrequeney catheter ablation（RFCA）, [Methods]The clinical and clectrophysiological characteristics, success rate, recurrence and complications of RFCA in 823 patients with AVNRT and AVRT were analysed retrospectively. [Results]Among all the patients, AVRT were more than AVNRT, females were more than males in patients with AVNRT, but a male preponderance was seen in the AVRT group（ P 〈0. 01 ）. Left accessory pathway was more than right accessory pathway in patients with AVRT, There was concealed accessory pathway preponderance in the left accessory pathway group while a dominant accessory pathway preponderance was seen in patients with right accessory pathway （ P 〈0.01 ）. There were more male than female patients with left accessory pathway, but females were more than males in patients with right accessory pathway （ P〈0.01 ）. The success rate in patients with right dominant accessory pathway was lower than that in patients with another accessory pathway and AVNRT（ P〈0.01 ）, but the recurrent rate in patients with right dominant accessory pathway was higher than that in patients with left accessory pathway（ P〈0.05 and P〈0.01 ）. The complications included 2 patients with complete atrioventricular block requiring permanent pacemaker implantation, 6 patients with pneumothorax and haemothorax,1 patient with cardiac tamponade, 3 patients with femoral pseudoaneurysm,1 patient with ventricular fibrillation, There was no mortality. [Conclusion]The success rate for AVNRT and AVRT is relative high, the recurrent rate and complications are quite lower, RFCA is a safe and effective method of treatment for patients with AVNRT and AVRT.
出处
《医学临床研究》
CAS
2005年第9期1200-1202,1206,共4页
Journal of Clinical Research
关键词
心动过速
房室结折返性
心动过速
tachycardia,atrioventr cular nodal rcentry
tachycardia
