射频消融治疗阵发性室上性心动过速132例分析

目的总结阵发性室上性心动过速（PSVT）导管射频消融（RFCA）治疗的临床经验。方法对132例行RFCA的PSVT患者的射频消融方法、成功率、复发率及并发症等资料进行回顾性分析。结果132例室上性心动过速中房室结折返性心动过速（AVNRT）49例，房室旁路折返性心动过速（AVRT）83例，消融总成功率90．2％。随访（87±20）月，AVNRT消融复发率13．3％，永久性Ⅲ°房室传导阻滞（AVB）发生率4．1％；AVRT消融复发率4．0％，永久性Ⅲ°AVB发生率1．2％。结论导管射频消融治疗PSVT安全、有效；熟练的心导管技术、仔细的电生理检查、耐心地寻找最满意的靶点图以及合适的消融能量和时间，是提高成功率和最大限度地减少并发症的关键。

The radiofrequency catheter ablation of PSVT:retrospective analysis of 132 cases

Objective To summarize the experience of radiofrequency catheter ablation （RFCA） for the treatment of paroxysmal supraventricular tachycardia （PSVT）. Methods Retrospective analysis was conducted regarding the methods, success and recurrence rate and clinical complication of radiofrequency catheter ablation（ RFCA）for the treatment of 132 patients with paroxysmal supraventricular tachycardia（PSVT）. Results One hundred and three patients with PSVT including atrioventricular reentrant in 83 and atrioventricular nodal reentrant tachycardla（AVNRT） in 49 by results of electrophysiological mapping, underwent RFCA procedures. The total success rate was 89%. During a mean follow-up of 87 ＋20 months ,the recurrence rate of ablating AVNRT was 13.3% ,the rate of permanent Ⅲ° atrioventricular block（AVB） was 4. 1% ,and the recurrence rate of ablating accessory pathway was 4. 0%, the rate of permanent Ⅲ° AVB was 1.2%. Conclusion RFCA for the treatment of PSVT is effective and safe. Accurate mapping,careful and skillful manipulating,and strict control of energy and time during ablation whould improve success rates ,and decrease the complication to a large extent.