射频消融疑难的房室结折返性心动过速(附三例分析)

回顾分析２２４例房室结折返性心动过速的射频消融结果，３例消融未成功，占１．３％。其中１例消融房室结造成Ⅲ度房室阻滞后仍有心动过速发作，提示房室结双径路下部共同通道的存在。消融不成功的原因可能为慢径不是一组纤维，且在解剖上快、慢径极为邻近，易同时受损。提示在遇到消融极为困难的病例，应酌情放弃消融，考虑更恰当的治疗方式，以避免因刻意追求消融成功而导致永久性房室阻滞的发生。

Radiofrequency Catether Ablation of Difficult Atrioventricular Nodal Reentry Tachycardia:A Report of Three Cases

This study retrospectively analyzed the radiofrequency catheter ablation (RFCA) results of 224 patients with atrioventricular nodal reentry tachycardia (AVNRT).There were 3 failure cases,the unsuccessful rate was 1.3%.One of them still had episode of tachycardia following complete atrioventricular block (AVB) caused by atrioventricular node (AVN) ablation,which prompted that there may be a common pathway occurred in the lower part of AVN.Analyzing the causes of unsuccessful cases,we inferred that slow pathway was not a single bundle of fibers and it was very near to the fast pathway anatomically.Sometimes the two pathways may be damaged at the same time.We should not blindly pursue the successful rate to cause permanent AVB and sometimes we should give up the ablation procedure when necessary,especially in the extremely difficult cases.