快速室上性心律失常后长间歇的临床分析

分析快速室上性心律失常后长间歇患者的临床特点及治疗。1350例射频消融术患者中,有12例表现为快速室上性心律失常后长间歇及反复黑矇/晕厥,对这些患者的临床资料进行分析并对其临床症状、动态心电图及心脏彩超结果进行随访。结果:12例患者电生理检查提示窦房结功能正常,均成功进行射频消融治疗,其中房室旁道5例,左、右房性心动过速各1例,房室结双径路1例,I型心房扑动1例,阵发性心房颤动(简称房颤)3例。射频消融术后随访,阵发性房颤组有1例(1/3,占33.3%)仍见短阵房颤或房性早搏后长间歇,另1例患者安装永久起搏器治疗,其他未见缓慢性心律失常及晕厥发作。结论:快速室上性心律失常后长间歇,可能是独立于病窦综合征之外的一种临床疾病。射频消融治疗快速室上性心律失常后,一般可改善缓慢性心律失常。

Clinical Analysis of 12 Patients With Long- Intermission After Supraventricular Tachyarrhythmia

To study the clinical characteristics and the treatment of the patients with long-intermission after supraventricular tachyarrhythmia, the clinical information of 12 patients,which were from 1 350 consecutive patients underwent radiofrequency catheter ablation (RFCA),were studied and follow-up of clinical symptom,dynamic electrocardiogram,and echocardiography was done. Results:The 12 patients all had normal function of sinoatrial node at following electrophysiology check,and received successful RFCA. Among the 12 patients, 5 patients were with atrioventricular accessory pathways ,1 with left-sided atrial tachycardia, 1 with right-sided atrial tachycardia, 1 with atrioventricular nodal reentrant tachycardia, 1 with type I atrial flutter, and 3 patients were with paraxysmal atrial fibrillation(PAF). During follow-up of 14.5±9.8 months after RFCA, onset of atrial fibrillation or long-intermission after premature atrial contraction were observed in 1 of 3 patiends with PAF, and a permanent cardiac pacemarker was implanted in 1 patient with persistent atrial flutter, no bradyarrhythmia and syncope were found in other patients. Conclusion: The incidence of long-intermission after supraventricular tachyarrhythmia is about 0.90%, it may be a single disease that is different from sick sinus syndrome. As the supraventricular tachyarrhythmias were cured by means of RFCA, bradyarrhythmias will be improved or even disappeared in these patients.