特殊类型房室结折返性心动过速的电生理机制及其射频消融

报道２例特殊类型的房室结折返性心动过速（ＡＶＮＲＴ），１例为慢－慢型ＡＶＮＲＴ伴起始部多径路逆传；１例为两种不同电生理特性的慢径交替前传、快径逆传构成的ＡＶＮＲＴ。电生理检查均提示房室结三径路。２例病人均于冠状静脉窦口上方消融慢径改良房室结成功，心动过速不再被诱发。随访２个月心动过速均无复发。提示房室结多径路形成的特殊类型ＡＶＮＲＴ，需详细的电生理检查并仔细鉴别方能予以诊断。射频导管消融方法同典型ＡＶＮ－ＲＴ，且安全、有效。

Electrophysiologic Mechanism and Radiofrequency Catheter Ablation Treatment of Atypical Atrioventricular Nodal Reentrant Tachycardia:Report of Two Cases

Two cases of atrioventricular nodal reentrant tachycardia (AVNRT) of special types were reported.One was AVNRT of slow slow type with initial multiple pathways retrograde conduction.The other was AVNRT with alternating cycle length,suggesting that two anterograde slow pathways were used alternatively and a retrograde fast pathway was used as a common way.Electrophysiologic study revealed multiple atrioventricular pathways in both cases.Radiofrequency catheter ablation successfully eliminated slow pathways and AVNRT could not be induced after ablation.No recurrence of the tachycardia was found during a few months follow up.This article suggests that careful electrophysiologic study should be done before AVNRT with multiple AV nodal pathways being diagnosed.The method of radiofrequency catheter ablation in atypical AVNRT is the same as that of typical AVNRT.