房室结功能曲线连续性房室结折返性心动过速患者的射频消融终点初探

目的　探讨房室结功能曲线连续性房室结折返性心动过速 (AVNRT)患者的射频消融终点。方法　在AVNRT患者中 ,对心房 A1 A2 和 A1 A2 A3程序刺激房室结功能曲线均呈连续性者为 组 ,A1 A2 刺激房室结功能曲线呈连续性而 A1 A2 A3刺激呈不连续性者为 a组 ,房室结功能曲线均呈不连续性者为 b组。行慢径区域消融后 ,对组间的电生理参数进行比较。结果　 组非典型 AVNRT的诱发率高于 组 (2 7.3 % vs5 .6% ,P<0 .0 5 )。在 I组和 a组 ,消融后最长 A2 H2 间期 (A2 H2 m ax)均比消融前有所缩短 ,但无显著性差异 (P>0 .0 5 ) ,而 b组则显著缩短 (3 76± 73 ms vs2 0 6± 5 6ms,P<0 .0 1)。消融后 组、 a组和 b组的最长 A3H3间期 (A3H3m ax)均比消融前显著缩短 (2 74± 71ms vs 196± 45 ms,P<0 .0 5 ;3 62± 91m s vs 2 2 6± 72 m s,P<0 .0 1;3 85± 88ms vs 2 19± 61ms,P<0 .0 1)。结论　非典型 AVNRT与房室结功能曲线的连续性有关。对于房室结功能曲线连续性的 AVNRT患者 ,消融后 A3H3max的缩短可作为消融终点的指标之一

Primary inquiry into the end point of radiofrequency ablation in patients with atrioventricular nodal reentrant tachycardia of continuous atrioventricular nodal function curve

ObjectiveTo inquire into the end point of radiofrequency ablation in patients with atrioventricular nodal reentrant tachycardia (AVNRT) of continuous atrioventricular nodal function curve.Methods All patients with AVNRT were divided into 3 groups, patients with continuous atrioventricular node (AVN) function curves during single and double atrial extrastimulation (A 1A 2, A 1A 2A 3) as groupⅠ, patients with continuous AVN function curves during A 1A 2 extrastimulation and discontinuous AVN function curves during A 1A 2A 3 extrastimulation as groupⅡa, patients with discontinuous AVN function curves during both A 1A 2 and A 1A 2A 3 extrastimulations as groupⅡb. After ablation in the zone of slow pathway, electrophysiological parameters were compared with that before and after ablation between groups.Results The inducing rate of untypical AVNRT in groupⅠwas higher than that in groupⅡ(27.3% vs 5.6%, P <0.05). The maximum A 2H 2 interval (A 2H 2max) shortened in groupⅡb (376±73ms vs 206±56ms, P <0.01), but the shortening after ablation in groupⅠand groupⅡa has no significant differences( P >0.05). The maximum A 3H 3 interval (A 3H 3max)shortened in groupⅠ, groupⅡa and groupⅡb(274±71ms vs 196±45ms, P <0.05;362±91ms vs 226±72ms, P <0.01; 385±88ms vs 219±61ms, P <0.01, respectively).Conclusion The untypical AVNRT correlated with continuous AVN function curves. The shortening of A 3H 3max could be determined as an indicator for the end point of radiofrequency ablation in patients with AVNRT of continuous AVN function curve.