摘要
目的：探讨持续性交接区反复性心动过速（ＰＪＲＴ）的电生理特点和导管射频消融（ＲＦＣＡ）的疗效。方法：７例患者（男３例；女４例）经心内电生理检查诊断为ＰＪＲＴ；心动过速发作或右室起搏时，沿房室环标测最提前的逆传房波（ＥＡＡ′）作为消融靶点，常规方法消融旁道，阻断其传导。结果：７例患者均呈典型阵发性室上性心动过速（ＳＶＴ）发作，但持续时间较长，心功能均正常。ＳＶＴ发作时Ｒ－Ｐ′间期较长，为（１９６±２４）ｍｓ，Ｒ－Ｐ′／Ｐ′－Ｒ比值多＞１，逆Ｐ波在下壁导联为负波。电生理检查证实均存在只有逆传功能的房室旁道，传导速度慢，靶点处Ｖ－Ａ间期为（１６３±２２）ｍｓ，并具有递减传导的特性。７条旁道分别位于右后间隔４条、右中间隔１条、左后间隔１条及左后壁１条。７例患者均１次手术成功，平均Ｘ线时间（１１±３）ｍｉｎ，无并发症。随访３～３４个月无复发。结论：ＰＪＲＴ是递减传导的房室慢旁道参与的一种特殊类型的房室折返性心动过速，ＲＦＣＡ是安全有效的根治方法。
Objective: To study the
electrophysiologic characteristics and the radiofrequency catheter ablation (RFCA) efficacy of
permanent junctional reciprocating tachycardia(PJRT). Methods: Seven patients (3 men, 4
women) with diagnosis of PJRT were confirmed at electrophysiologic study. Radiofrequency
energy was applied at the site of atrioventricular annulus with the earliest retrograde atrial
activation during tachycardia or right ventricular pacing. The accessory pathway was ablated to
block its conduction using routine RFCA method. Results: All patients had typical attacks of
supraventricular tachycardia with normal heart function, some of them were incessant. During
tachycardia long RP intervals, (19624) ms, were found, and RP/ PR ratios were mostly greater
than 1 with retrograde P waves negative in the inferior leads. Electrophysiologic studies
demonstrated all patients with concealed slow conducting accessory pathway for retrograde
conduction. At the ablation sites VA intervals were (16322) ms,conducting properties could be
found. Seven accessory pathways were located in right posteroseptal in 4 patients, right
midseptal in 1, left posteroseptal in 1 and left posterior in 1. All ablations were successful at the
first operation with a mean of (113) min of Xray time, and without adverse effects. During the
followup, all patients remained free from tachycardia. Conclusion: PJRT is a special type of
atrioventricular reentry tachycardia through concealed slow and decremental conducting
accessory pathway. Catheter ablation is an effective and safe curative treatment.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
1999年第5期322-324,共3页
Academic Journal of Second Military Medical University
关键词
心动过速
室上性
射频消融术
PJRT
RFCA
catheter ablation
radiofrequency current
tachycardia
supraventricular
electrophysiology and decremental
