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经导管射频消融治疗不典型房室结折返性心动过速的临床分析

Clinical Analysis of Radiofrequency Catheter Ablation in Treatment of Atypical Atrioventricular Nodal Reentrant Tachycardia
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摘要 目的评估射频消融术对不典型房室结折返性心动过速治疗效果.方法自2007年1月至2012年6月,昆明医科大学附属延安医院收住的673例房室结折返性心动过速(AVNRT)患者接受射频消融术治疗,其中慢快型AVNRT患者636例(典型AVNRT组),快慢型AVNRT患者16例和慢慢型AVNRT患者31例(不典型AVNRT组),所有患者均在窦性心律下或心房起搏下接受慢径消融术.结果不典型AVNRT组和典型AVNRT组在操作时间、急性期成功率方面比较差异无统计学意义,分别为(63±21)min vs(67±29)min和100%vs100%,P>0.05,不典型AVNRT组的复发率高于典型AVNRT组,为6.3%vs 1.4%,P<0.05,2组患者均未出现严重消融相关并发症.结论射频消融术治疗不典型AVNRT安全有效. Objective To evaluate the efficacy of radiofrequency catheter ablation in the treatment of atypical atrioventricular nodal reentrant taehycardia （AVNRT） Methods From January 2009 to June 2012, 673 consecutive patients with AVNRT were enrolled, among which 636 patients were slow-fast AVNRT （typical AVNRT group） , the other 16 patients were fast-slow AVNRT and 31 patients were slow-slow AVNRT （atypical AVNRT group） . All patients were received catheter ablation slow pathway during sinus rhythm or atrial pacing which ensure 1：1 conduction via the fast pathway. Results There were no significant differences in operation time and acute success rate between atypical AVNRT group and control group （P 〉 0.05）, which were （63 ± 21） min vs （67 ± 29） min and 100% vs 100%, respectively. The recurrence rate of atypical AVNRT group was significant greater than that of control group, 6.3% vs 1.4% （P 〈 0.05） Conclusion Radiofrequency catheter ablation of the slow pathway is a feasible and efficient approach to treat atypical AVNRT.
作者 张小勇 潘伟 马敏 尹淇 李绍龙 付娟娟 盖起明 光雪峰
机构地区 昆明医科大学附属延安医院心内科 南方医科大学附属南海医院心内科
出处 《昆明医科大学学报》 CAS 2015年第1期85-88,共4页 Journal of Kunming Medical University
基金 云南省自然科学基金资助项目(2010CA010)
关键词 射频消融 房室结折返性心动过速 慢径 Radiofrequency catheter ablation Atrioventricular nodal reentrant tachycardia Slow pathway
分类号 R541.71 [医药卫生—心血管疾病]
  • 相关文献

参考文献8

  • 1ESTNER H L, NDREPEPA G, DONG J, et al. Acute and long-term results of slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia-Ananalysis ofthe predictive factors for arrhythmia recurrence [ J ]. Pacing Clin Electrophysiol, 2005,28 (2) : 102- 110.
  • 2KATRITSIS D G, CAMM A J. Classification and differential diagnosis of Atrioventricular nodal re-entrant tachycardia[J].Europace,2006,8(1 ):29-36.
  • 3OTOMO K,WANG Z,LAZARRA R,JACKMAN W M. A- trioventricular nodal reentrant tachycardia: electrophysio- logical characteristics of four forms and implications for the reentrant circuit. In:Zipes DP, Jalife J, editors. Cardiac electrophysiology: from cell to bedside [M]. 3rd ed, Philadelphia: WB Saunders Company, 1999:504-521.
  • 4COSIO F G,ANDERSON R H,KUCK K H,et al. ESCW- GA/NASPE/P experts consensus statement: living anatomy of the atrioventricular junctions. A guide to electrophysio- logic mapping .Working Group of Arrhythmias of the Euro- pean Society of Cardiology. North American Society of Pac- ing and Electrophysiology [J].J Cardiovasc Electrophysiol,1999,10(8):1 162-1 170.
  • 5JACKMAN W M, BECKMAN K J, MCCLELLAND J H, et al. Treatment of supraventricular tachycardia due to atri- oventricular nodal reentry by radiofrequency catheter abla- tion of slow pathway conduction [J ]. N Engl J Med, 1992,327(5):313-318.
  • 6HAISSAGUERRE M, GAITA F, FISCHER B, et al. Elimi- nation of atrioventricular nodal reentry tachycardia using slow potentials to guide application of radiofrequency energy [J]. Circulation,1992,85(6):2 162-2 175.
  • 7张小勇,盖起明,薛强,左明鲜,邓洁,尹昵.心房起搏下消融房室结慢径的研究[J].昆明医学院学报,2010,31(8):65-68. 被引量：1
  • 8NAKAGAWA H, JACKMAN W M. Catheter ablation of p- aroxysmal supraventricular tachycardia [ J ]. Circulation, 2007,116(21 ) : 2 465 -2 478.

二级参考文献11

  • 1ESTNER H L, NDREPEPA G, DONG J, et al. Acute and long-term results of slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia-Ananalysis of the predictive factors for arrhythmia recurrence [J]. Pacing Clin Electrophysiol, 2005,28 : 102 - 110.
  • 2JENTZER J H,GOYAL R,WILLIAMSON B D,et al. Analysis of junctional ectopy during radiofrequency ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia [J]. Circulation, 1994,90 : 2820 - 2826.
  • 3HINTRINGER F, HARTIKAINEN J, DAVIES D W, et al. Prediction of atrioventricular block during radiofrequency ablation of the slow pathway of the atrioventricular node [J]. Circulation, 1995,92 : 3490 - 3496.
  • 4OTOMOKK, WANG Z, LAZARRA R, et al. Atrioventricular nodal reentrant tachycardia:eleetrophysiological characteristics of four forms and implications for the reentrant circuit [M].In:ZIPES D P,JALIFE J,editors. Cardiac electrophysiology:from cell to bedside 3rd ed Philadelphia, PA:WBSaunders Company, 1999 : 504-521.
  • 5COSIO F G,ANDERSON R H,KUCK K H,et al. ESC - WGA/NASPE/P experts consensus statement: living anatomy of the atrioventricular junctions.A guide to electrophysiologic mapping.Working Group of Arrhythmias of the European Society of Cardiology. North American Society of Pacing and Electrophysiology[J]. J Cardiovasc Electrophysiol, 1999, 10:1162 - 1170.
  • 6KATRITSIS D G, CAMM A J. Classification and differential diagnosis of Atrioventricular noda re-entrant tachycardia[ J ]. Europace, 2006,8 : 29 - 36.
  • 7JACKMAN W M,BECKMAN K J,MCCLELLAND J H, et al. Treatment of supraventricular tachycardia due to atrioventricular nodal reentry by radiofrequency catheter ablation of slow pathway conduction [ J ]. N Engl J Med , 1992,327:313 - 318.
  • 8HAISSAGUERRE M, GAITA F, FISCHER B, et al. Elimination of atrioventricular nodal reentry tachycardia using slow potentials to guide application of radiofrequency energy[ J ]. Circulation, 1992,85:2162 - 2175.
  • 9NAKAGAWA H,JACKMAN W M. Catheter ablation of paroxysmal supraventricular tachycardia [J ]. Circulation ,2007,116 : 2465 - 2d78.
  • 10LEE S H,TAI C T,LEE P C,et al. Eleetrophysiological characteristics of junctional rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia [J]. Pacing Clin Electrophysiol , 2005,28:111 - 118.
昆明医科大学学报
2015年 第1期

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