射频消融治疗具有快频率依赖性室房逆传特性的旁道

目的报道具有快频率依赖性室房逆传特性的房室旁道电生理检查及射频消融结果。方法4例患者,均有阵发性心悸史,且发作时心电图均显示为窄QRS波心动过速,按常规方法接受心脏电生理检查及射频消融治疗。结果4例均证实存在旁道的快频率依赖性室房逆传,且均诱发了房室折返性心动过速,室房逆传最早激动部位均为左房。于快频率心室刺激下标测消融靶点,消融均获成功。结论旁道的快频率依赖性传导为一种少见电生理现象,可伴发房室折返性心动过速。

Radiofrequency catheter ablation of atrioventricular accessory pathway with rapid rate dependent ventriculoatrial conduction

Objective To report 4 cases of atrioventricular accessory pathway with rapid rate dependent ventriculoatrial conduction and summarize the experience of electrophysiological study and radiofrequency catheter ablation in these cases.Methods Four patients,who all had symptoms of paroxysmal palpitation and whose electrocardiograms recorded at the onset of tachycardia all manifested as narrow QRS complex,underwent electrophysiological study and radiofrequency catheter ablation by the routine method.Result In all patients that special kind of atrioventricular accessory pathway with rapid rate dependent ventriculoatrial conduction were demonstrated to exist by electrocardiophysiological study and the atrioventricular reentrant tachycardia with the earliest atrial activated site located in the left atria were induced.Targets for ablation were identified during rapid rate ventricular pacing and a successful ablation was attained in every patient.Conclusion Rapid rate dependent conduction of atrioventricular accessory pathway is existent as a rare phenomenon and this special kind of accessory pathway can also induce atrioventricular reentrant tachycardia,which should be paid attention to in case it should be misdiagnosed.