房室结慢径消融对心房电生理性质的影响

Objective The ablation of the atrioventricular node slow pathway may reduce the inducibility of atrial fibrillation (AF) ,but the mechanisms remain unknown. We tried to investigate the impact of ablation on atria refractory period, and to elucidate the underlying mechanism. Methods Thirty-two patients with atrioventricular node reentrant tachycardia (AVNRT) were enrolled in the study. Atria effective refractory period (ERP) and vulnerable window (VW) at high right atrium (HRA),inferior right atrium (IRA),distal (CSd) and proximal CS (CSp) ,as well as sinus rate (SR) and effective refractory period of fast pathway (FERP) were measured before and after ablation. Results ( 1 ) After ablation, the ERP at HRA did not change:(214. 4 ± 35. 1 ) ms, (213.4 ± 37. 3) ms, P = 0. 6, on the other hand, the ERPs at following sites were significantly prolonged:CSp(218. 1 ±21.8)ms, (235.3 ± 23.6) ms,P ＜0. 0001 ;CSd(230. 9 ±21.0) ms, (244. 7 ±25. 1)ms,P＜0. 01;IRA(198.8 ±26.7)ms,(219.7 ±28. 7) ms,P ＜ 0.005,respectively. (2) The VW of HRA remained unchanged after ablation, while the VWs of CSp, CSd and IRA trended to decline despite no statistic significant. (3)SR showed a little increasing but without statistic significant after ablation (P = 0. 17 ).(4) ERP of fast pathway was significantly decreased after ablation: ( 391 ± 55 ) ms, ( 369 ± 78 ) ms, P ＜ 0. 01.Conclusions The decrease of ERPs at CS and IRA, as well as F-ERP after ablation may decline the inducibility of atrial fibrillation and indicates regional vagal denervation to the atrium.

Impact of slow pathway ablation on atrial electrophysiology