冷冻消融与射频消融治疗房室结折返性心动过速的比较

目的:比较经导管冷冻消融与射频消融治疗房室结折返性心动过速(AVNRT)的临床效果及安全性.方法:根据治疗方法将83例经电生理检查确诊为AVNRT的患者分为冷冻消融组(冷冻组,n=41)和射频消融组(射频组,n=42).比较两组的临床特征、成功率、手术时间及复发率等.结果:两组一般临床特点无明显差异.冷冻组的手术时间明显比射频组长[(119.14±40.16)min vs (85.86±28.24)min,P=0.001],差异有统计学意义.冷冻组和射频组消融即刻成功率相似(97.6% vs 100.0%,P=0.309),差异无统计学意义.冷冻组较射频组一过性房室传导阻滞(AVB)的发生率稍高(15.0% vs 11.9%,P=0.681),但差异无统计学意义,且两组均无完全AVB发生.两组患者在平均(11.6±5.5)个月的随访期内均无AVNRT复发.结论:冷冻消融治疗AVNRT与射频消融一样有效且安全.冷冻消融可作为AVNRT的常规消融方式之一.

Transvenous Cryoablation Versus Radiofrequency Catheter Ablation for Treatment of Atrioventricular Nodal Reentrant Rachycardia

Objective:To compare the efficacy and safety between cryoablation(Cryo)and radiofrequency (RF)ablation in patients with atrioventricular nodal reentrant tachycardia(AVNRT). Methods: A total of 83 patients with AVNRT underwent electrophysiological treatment in our hospital from October 2006 to March 2009 were studied. Patients were divided into two groups according to their own choices. Cryo group (n=41) and RF group (n=42). The clinical characteristics,success rate,procedural time and ablative time were compared between two groups. Results:The procedural time and ablative time in Cryo group was significantly longer than those in RF group (119.14±40.16 min vs.85.86±28.24 min,P=0.001; 1118.91±620.62 s vs.370.97±279.23 s,P<0.001). The acute success rate was achieved in 40/41(97.6%)patients in Cryo group,and 42/42(100.0%) in RF group. Transient AV-block was encountered in 6 (15%) patients in the Cryo group and 5 (11.9%) in RF group (P=0.681). There was no complete atrial-ventricular(AV)conduction block at the end of procedures. There was no recurrence of AVNRT in either Cryo group nor in RF group during 11.6±5.5 months of follow up period.Conclusion:Cryoablation was as effective and safe as RF ablation for AVNRT. Cryo-energy was one kind of alternative ablation energy for AVNRT.