多种类型房室结折返性心动过速的电生理特点

目的 探讨多种类型房室结折返性心动过速（AVNRT）的电生理特征及消融体会。方法 回顾性分析成功行射频导管消融的113例AVNRT病人的临床和心内电生理资料。结果 113例AVNRT患者中6例存在多种类型AVNRT，其中存在2种、3种和4种类型AVNRT者各占2例，共有8种类型AVNRT；2例存在MAVNP，其余4例DAVNP阳性；均在慢径路区域行射频消融，放电时出现交界性早搏和/或心律，放电次数，功率、时间和X线曝光时间与同期慢-快型AVNRT相似，术后应用阿托品或异丙基肾上腺素未再诱发室上性心动过速，亦无回波，术中和术后均无房室传导阻滞，随访2.0-25.5月，无1例复发。结论 多种类型AVNRT并不少见，中径路既有逆传功能，也具有前传功能，多种类型AVNRT的射频消融类似于慢-快型AVNRT，安全有效。

Electrophysiologic characteristics and radiofrequency catheter ablation in patients with multiple atrioventricular nodal reentry tachycardias.

Objective To investigate the electrophysiologic characteristics and radiofrequency catheter ablation(RFCA) in patients with multiple atrioventricular nodal reentry tachycardias (AVNRT).Methode Information about the electrophysiologic study and RFCA in 113 patients with AVNRT was analyzed.Results Among the 113 consecutive patients with AVNRT,6 with multiple forms of AVNRT were included in this study.2 patients had 2 types,2 had 3 types,2 had 4 types,together 8 types of AVNRT.DAVNP were seen in 4 patients and MAVNP in 2.All patients had modification of the slow pathway and junctional premature beat and/or junctional parasystole during ablation.After ablation all patients had not inducible tachycardia or echoboth in a baseline state and during an Isoproterenol or Atropin infusion,atrioventricular block was not found.During the follow-up period of 2.0-25.5 months,all patients had not recurrence of tachycardia.Conclusions Multiple AVNRT is not rate in patients with AVNRT,intermediate pathway can both retrograde and antegrade conduct,RFCA is safe and effective in eliminating critical slow pathways to cure multiple AVNRT.