补充线性消融房室结双径路残存慢径的临床分析

目的探讨房室结折返性心动过速（AVNRT）经常规方法消融后残存慢径采取Koch三角基底部补充线性消融后电生理特性变化以及临床疗效。方法将160例AVNRT经常规方法消融成功后残存慢径患者49例,随机分为线性消融组（25例）和对照组（24例）。电生理检查分别记录线性消融前两组残存慢径路有效不应期（ERP）以及最大AH间期（A-Hmax）,线性消融组残存慢径阻断率（如经线性消融残存慢径未能阻断则记录慢径路的ERP和A-Hmax的改变情况）以及两组复发情况。结果对照组残存慢径路平均ERP为（288.6±56.0）ms,平均A-Hmax为（306.9±52.0）ms。线性消融组补充消融前慢径路平均ERP为（279.0±45.0）ms,平均A-Hmax为（312.9±66.8）ms,两组术前各项参数比较差异无统计学意义（P〉0.05）。线性消融组补充消融后15例慢径路阻断,未能阻断的10例慢径路平均ERP增加至（310.6±67.0）ms,平均A-Hmax缩短为（280.9±52.0）ms,与对照组比较差异具有统计学意义（P〈0.05）。线性消融组术中1例出现一过性Ⅲ度AVB,停止放电后恢复正常。随访1年,对照组有4例复发,线性消融组无复发,差异具有统计学意义（P〈0.05）。结论采取Koch三角基底部线性消融改良房室结双径路是提高射频消融治疗AVNRT成功率的一种安全有效的方法,可作为常规消融法的补充术式。

Treatment of Additional Straight Linear Approach in Atrioventricular Nodal Dual Path-Ways after Radiofrequency Ablation of the Slow Pathway

Objective To investigate the atrioventricular nodal reentrant tachycardia conventional method of residual slow pathway after ablation linear approach in the Koch's triangle changes in electrophysiological properties and clinical efficacy.Methods Among 160 patients with AVNRT after successful ablation by conventional methods,the 49 patients with residual slow pathway were randomly allocated to the linear ablation group(25 cases) and control group(24 cases).Electrophysiology ablation were recorded before the ...