房室结内折返性心动过速慢径路消融中房室传导阻滞的预防

目的 探讨房室结内折返性心动过速(AVNRT)慢径路消融中房室传导阻滞的预防措施。方法 72例AVNRT患者从小功率(5W)开始放电，逐步增加放电功率，根据放电时的反应，及时改换安全的放电部位；放电过程中不苛求房室交接区心律从有到无的规律；慢径路改良，不苟求慢径路消失，以不诱发心动过速为宗旨。结果 72例慢径路消融均成功，无一例发生房室传导阻滞的并发症，无一例远期复发。结论 从小功率开始放电，慢径路改良等措施，可有效预防房室传导阻滞，且对远期复发无影响。

Prevention of atrioventricular block during radiofrequency ablation of slow pathway in atrioventricular nodal reentry tachycardia

Objective To study preventive methods of atrioventricular block during radiofrequency ablation of slow pathway in atrioventricular nodal reentry tachycardia. Methods Seventy two patients with AVNRT underwent radiofrequency ablation. Radiofrequency energy was low (5W) at beginning of ablation and increased gradually and ablation site altered promptly according to response to ablating. Regular pattern of junctional rhythm from having to nothing was not absolutely necessarily and aim of ablation was slow pathway modification without inducing tachycardia instead of slow pathway abolition during ablating. Results Slow pathway was ablated successfully without any atrioventricular block occurring in all 72 patients and none had tachycardia relapsing at a specified future date. Conclusion Radiofrequency ablation beginning from low power and slow pathway modification are effective methods to prevent atrioventricular block during procedure and recurrence of tachycardia in future.