射频消融术治疗室上性心动过速及对心肌损伤的研究

目的：评价导管射频消融术（RFCA）治疗室上性心动过速（PSVT）的安全性及射频电流对心肌的影响。 方法：选择216例阵发性室上性心动过速患者（男112例，女104例），平均年龄(43.3±14.0)岁，经心内电生理检查证实为房室折返性心动过速（AVRT）或房室结折返性心动过速（AVNRT），并进行导管射频消融术治疗，观察成功率、复发率及并发症。测其术前及术后2 h血肌钙蛋白T（cTnT）浓度。 结果：RFCA治疗PSVT中AVRT消融成功率为97.1%，AVNRT消融成功率为98.7%，总成功率为97.6%（211/216）。AVRT消融复发率3.6%，AVNRT消融复发率5.1%，总复发率为：4.16%。并发症发生率：1.8%。216例PSVT患者术后2 h cTnT浓度［（0.850±0.083）μg•L^-1］与术前cTnT浓度［（0.132±0.002）μg•L^-1］比较，差异具有显著性(P<0.05)，101例射频消融单次放电术后2 h cTnT浓度［（0.630±0.142）μg•L^-1］与115例2次或2次以上放电术后2 h cTnT浓度［（1.200±0.091）μg•L^-1］比较，差异具有显著性(P<0.05)。 结论：导管射频消融术治疗阵发性室上性心动过速安全且效果确切。

Investigation on security of treatment of PSVT with radiofrequency catheter ablation and cardiac muscle injury

Objective To evaluate the security of the treatment of paroxysmal supraventricular tachycardia (PSVT) with radiofrequency catheter ablation (RFCA), and observe the effect of radiofrequency energy on cardiac muscle. Methods 216 patients with PSVT (male 112, female 104) ,mean age (43.3±14.0) years old, were included. RFCA was performed in all patients with atrioventricular nodal reentrant tachycardia (AVNRT) or atrioventricular reentrant tachycardia (AVRT) proved by electrophysiological testing. The success rate, recurrence rate and complications were investigated. The contents of cardiac troponin T(cTnT) in patients before operations and 2 hours after operation were measured. Results The success rates of AVRT and AVNRT patients were 97.1%(134/138) and 98.7%(77/78),respectively. The total success rate was 97.6%(211/216). The recurrence rates of AVRT and AVNRT patients were 3.6% and 5.1%, respectively. The total recurrence rates was 4.16%. Complications occurred in 5 patients (1.8%). The concentration of cTnT(0.850±0.083 μg·L -1 )in 216 patients 2 h after operation significantly increased compared with that in patients before operation (0.132±0.002 μg·L -1 ). The concentration of cTnT in 115 patients of twice and more twice discharged (1.200± 0.091 μg·L -1 ) significantly increased compared with that in 101 patients of once discharged 2 hours after operation (0.630± 0.142 μg·L -1 ). Conclusion RFCA is an effective and safe method for PSVT.