房室折返性心动过速合并阵发性心房颤动的射频导管消融策略

目的探讨房室折返性心动过速（AVRT）合并阵发性心房颤动的射频导管消融（下称消融）策略。方法对经电生理检查证实的AVRT患者15例行旁道消融术，其中男性9例，女性6例，并对术后心房颤动的转归进行12～36个月的随访，观察心房颤动发生、持续时间、有无心律失常等情况。结果13例未再发生心房颤动，2例有严重器质性心脏病的患者仍有阵发性心房颤动复发，但发作次数明显减少，口服胺碘酮可控制症状。1例动态心电图示频发房性期前收缩。结论AVRT与阵发性心房颤动发生率增高密切相关，AVRT是心房颤动的触发因素。旁道消融后，阵发性心房颤动可明显改善，未改善者与心房扩大等心房基质未改善有关。

The Effect of Radiofrequency Catheter Ablation of Atrioventdcular Reentrant Tachycardia on Paroxysmal Atrial Fibrillation

Objective To assess the effect of radiofrequency catheter ablation （RFCA） of atrioventricular reentrant tachycardia （AVRT） on coexisting paroxysmal atrial fibrillation （AF）. Methods Fifteen patients （9 male, 6 female） with AVRT and paroxysmal AF underwent RFCA of accessory pathways and were followed up from 12 to 36 months. Results Paroxysmal AF reoccurred in only two cases with overt heart disease after RFCA of accessory pathways and its attack decreased obviously. Frequent premature atrial beats were detected by ambulatory electrocardiography in one case. Conclusion AVRT is closely related to paroxysmal AF and the main cause of AF in patients with both AVRT and paroxysmal AF. Ablation of accessory pathways may prevent paroxysmal AF.