射频消融治疗快速型心律失常临床分析

目的 分析总结经导管射频消融（RFCA）治疗快速型心律失常特别是阵发性房室结内折返性心动过速（AVNRT）和房室折返性心动过速（AVRT）的疗效，以指导临床工作。方法 回顾性分析418例经导管射频消融治疗快速型心律失常患者的治疗效果，包括房室结内折反性心动过速（AVNRT）130例，左侧旁道230，右侧旁道45例，室性心动过速（IVT）10例，房性心动过速3例，采用常规方法进行电生理检查和射频消融。结果 总成功率97．9％，其中房室结双径路和左侧房室旁道介导的阵发性室上速射频消融成功率高达98％以上。射频消融术后复发率2．9％，其中AVNRT复发3例，AVRT复发8例。IVT复发1例，12例再次RFEA均获成功。3例发生完全性房室传导阻滞，2例植入心脏起搏器，1例损伤主动脉瓣，引起反流。2例出现深静脉血栓及肺栓塞，无死亡病例。结论 经导管射频消融是治疗快速型心律失常安全有效的方法，适合于各类人群，以AVNRT和AVRT效果最好。

Clinical analysis on patients with tachycardia who underwent radiofrequecy catheter ablation

Objective To analyze the outcomes of patients with tachycardia who underwent radiofrequecy catheter ablation and provide guidelines for further clinical works.Methods Clinical outcomes of 418 subjects with tachycardia who had undergone radiofrequecy catheter ablation were retrospectively analyzed.130 cases of atrioventricular nodal reentrant tachycardia(AVNRT),275 cases of accessory pathways(230 left accessory pathways,45 right accessory pathways),10 cases of ventricular tachycardia(VT),3 cases of artrial tachycardia(AT) were included,normal methods were used to carry out electrophysiological test and radiofrequency catheter ablation.Results The overall success rate was(97.9%,)in which radiofrequency catheter ablation of supraventricular tachycardias mediated by dual artriovetricular nodes and left-sided accessory pathway had a higher success rate(above 98.0%).The recurrence rate was 2.9% after radiofrequency catheter ablation,three of them were AVNRT,eight of them were AVRT and one of them were AT.Complete atrioventricular block took place in three patients during procedure,and pacemakers were implants in two patient.One patient complicated with injured aorta valve and regurgitation.Two patient had vonous and pulmonary embolism.None patient died.Conclusion Radiofrequency catheter ablation can be performed effectively and safely in different population,especially in patients with AVRT and AVNRT.