导管射频消融治疗飞行员快速心律失常临床分析

目的探讨导管射频消融（RFCA）在治疗飞行员多种快速性心律失常中的安全性及临床应用价值，探讨飞行员快速性心律失常的航空医学鉴定标准。方法对13例快速性心律失常的飞行员进行了电生理（EP）检查，特发性室性心动过速（VT）1例，频发室性期前收缩（VE）2例，阵发性心房纤颤（AF）1例，房室折返性心动过速（AVRT）5例，房室结折返性心动过速（AVNRT）3例，房性心动过速（AT）1例。对其中12例采用RFCA治疗。结果RFCA即刻成功率为100％，全组无并发症发生。1例房性心动过速未行导管射频消融治疗。所有飞行员术后地面观察6个月后，返院进行随访复查，同时进行飞行鉴定。12例导管射频消融治疗，术后6个月24h动态心电图、12导联心电图检查和食道电生理检查均未检测到术前的同型快速性心律失常发作，延迟成功率为100％，医学鉴定合格。1例AT仍有发作，飞行不合格。结论对于飞行员快速性心律失常进行导管射频消融治疗是一种安全、有效的治疗方法。心脏电生理检查应作为飞行员快速性心律失常医学鉴定的主要指标之一。

Clinical analysis of radio frequency ablation on tachyarrhythmias in pilots

Objective To study the clinical value of the radio frequency catheter ablation(RFCA)and on pilots's various tachyarrhythmias.Methods Electrophysiologic(EP)examination was performed in 13 pilot cases and RFCA was performed in 12 pilot cases,include ventricular tachycardia(VT)1 case,ventricular extrasystole(VE)2 cases,atrioventricular reentrant tachycardia(AVRT)5 cases,atrioventricular nodal reentrant tachycardia(AVNRT)3 cases,atrial fibrillation(AF)1 case.All cases return to hospital proceed follow-up after six months observation on ground.Results The succeed rate was 100%,no severity complication in 12 ablation cases.24 h Holter and 12 lead electrocardiograph couldn't find tachyarrhythmias.Tachyarrhythmias couldn't be found by EP after six months.1 case failed in ablation and onset atrial tachycardia(AT).Conclusions Radio frequency ablation is safe and effective to cure tachyarrhythmias in pilots.EP examination should be one of the main criterion of medical assessment.