老年室上性心动过速的射频消融治疗

目的 :评价射频消融治疗对老年室上性心动过速的疗效及如何提高术前对心动过速类型的鉴别能力。方法 :对 3 0例接受射频消融的老年室上性心动过速患者进行分析 ,就其发病年龄、病程、手术时年龄进行对比分析。结果 :3 0例患者中显性预激综合征 6例 ,隐匿性预激综合征 9例 ,房室结折返性心动过速 15例。隐匿旁道所致 AVRT射频消融成功率为 10 0 % ,AVNRT射频消融成功率 10 0 % ,显性旁道所致 AVRT射频消融成功率83 .3 % ,总的射频消融成功率为 96.7%。多旁道的发生率为 2 0 % ,无并发症发生。 AVRT(隐匿旁道 )与 AVNRT组比较 ,前者发病年龄低于后者 (3 4.1± 16.7对 5 0 .1± 13 .6,P<0 .0 5 ) ,病程前者高于后者 (2 9.8± 18.4对 14 .8± 12 .9,P<0 .0 5 ) ,二者在手术时年龄无显著性差异 (P>0 .0 5 )。其余两两比较 ,在发病年龄、病程、手术时年龄方面 ,均无显著性差异。结论 :射频消融治疗老年患者的室上性心动过速安全、有效。对平素心电图正常的老年室上性心动过速患者 AVNRT的发生率高于 AVRT。结合患者发病年龄及病程可帮助判定其心律失常的类型 ,为临床治疗提供依据

RADIOFREQUENCY CATHETER ABLATION IN OLDER PATIENTS WITH SUPRAVENTRICULAR TACHYCARDIA

Objective:To observe the efficacy of radiofrequency catheter ablation (RFCA) on supraventricular tachycardia in older patients and to enhance the differentiating ability for typing the supraventricular tachycardia.Methods:Thirty patients who had undergone RFCA were comparatively analyzed for their ages of initial tachycardia attack,course,and the age when RFCA was received.Results:There were 6 cases of dominant preexcitation syndrome,9 cases of concealed preexcitation and 15 cases of atrioventricular nodal reentrant tachycardia (AVNRT).The RFCA success rate was 100% in atrioventriculare reentrant tachycardia(AVRT) induced by concealed accessory pathway(CAP);it was also 100% in AVNRT group.The RFCA success rate was 83.3% in AVRT induced by dominant accessory pathway (AP).The total success rate was 96.7%.The incidence of multiple AP was 20% without complications occurred.The age of initial tachycardia attack in AVRT(with concealed AP) group was younger than that in AVNRT group (34.1±16.7 vs 50.1±13.6,P<0 02) and the course was longer in the former (29.8±18.4 vs～14.8±12 9,P<0 05)).There was no significant difference of RFCA operation ages between the two groups (P>0 05).Conclusion:RFCA is safe and efficient in older patients with supraventricular tachycardia;the incidence of AVNRT is higher than AVRT in older patients.Taking the initial attack ages and disease-process into consideration,we can identify the arrhythmia types,providing a basis for clinical therapy.