能量滴定法在慢径改良术中预防房室传导阻滞的作用研究

目的探讨“能量滴定法”在射频消融治疗房室结折返性心动过速术中对房室传导阻滞的预防作用。方法收集经射频消融术治疗的房室结折返性心动过速865例;消融过程采用“下位法+能量滴定法”。结果治疗成功率98.9%,复发率为2.08%,10例患者出现I°房室传导阻滞,无III°房室传导阻滞发生。靶点数≥5.0、有效靶点/总靶点<70%和累计消融能量(W*S)≥2300的患者房室传导阻滞的发生率明显增高(P<0.05),而复发率则无明显差异。结论射频消融术治疗房室结折返性心动过速减少累计消融能量、控制总靶点数和提高靶点有效率能有效减少房室传导阻滞的发生。

Preventing the Atrioventricular Block in RFCA for the treatment of AVNRT

Objective To discuss the prevention of atrioventricular block during radio-frequency ablation(RFCA) for the treatment of atrioventricular nodal reentrant tachycardia(AVNRT).Methods Total 865 patients with atrioventricular nodal reentrant tachycardia treated with RFCA were studied.Energy discharge approach was used.Results The success rate for AVNRT was 99.42%.Recurrence rate was 2.08%.1°atrial-ventricular block developed in 10 patients.The patients with target sites ≥5.0,ratio of effective target sites/total sites <70% and total energy output(W*S) ≥2300 were more likely to develop atrial-ventricular block(AVB)(P<0.05).There was no remarkable difference in the recurrence rate.Conclusions During RFCA for the treatment of AVRT,decrease the total energy output and the target sites,increase the effective target sites can decrease the occurrence of AVB.