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| 射频消融治疗持续性交接区反复性心动过速 |
| 毛红娟,卢岩,季品芳,曹爱芳,边长勇,陈少萍,胡坚强,周炳炎,秦永文,曹江 |
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| 摘要: |
| 目的：探讨持续性交接区反复性心动过速(PJRT)的电生理特点和导管射频消融（RFCA）的疗效。方法：7例患者（男3例；女4例）经心内电生理检查诊断为PJRT；心动过速发作或右室起搏时，沿房室环标测最提前的逆传房波（EAA′）作为消融靶点,常规方法消融旁道,阻断其传导。结果：7例患者均呈典型阵发性室上性心动过速（SVT）发作，但持续时间较长，心功能均正常。SVT发作时R-P′间期较长，为（196±24）ms，R-P′/P′-R比值多>1，逆P波在下壁导联为负波。电生理检查证实均存在只有逆传功能的房室旁道，传导速度慢，靶点处V-A间期为（163±22）ms，并具有递减传导的特性。7条旁道分别位于右后间隔4条、右中间隔1条、左后间隔1条及左后壁1条。7例患者均1次手术成功，平均X线时间（11±3）min，无并发症。随访3-34个月无复发。结论：PJRT是递减传导的房室慢旁道参与的一种特殊类型的房室折返性心动过速，RFCA是安全有效的根治方法。 |
| 关键词: 导管消融 射频电流 心动过速，室上性 |
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| Radiofrequency catheter ablation for permanent junctional reciprocating tachycar dia |
| 毛红娟,卢岩,季品芳,曹爱芳,边长勇,陈少萍,胡坚强,周炳炎,秦永文,曹江 |
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| Abstract: |
| Objective: To study the electrophysiologic characteristics and the radiofrequency catheter ablation (RFCA) efficacy of permanent junctional re ciprocating tachycardia(PJRT). Methods: Seven patients (3 men , 4 women) with diagnosis of PJRT were confirmed at electrophysiologic study. Radiofrequency energy was applied at the site of atrioventricular annulus with the earliest retrograde atrial activation during tachycardia or right ventricular pacing. The accessory pathway was ablated to block its conduction using routine RFCA method. Results: All patients had typical attacks of sup raventricular tachycardia with normal heart function, some of them were incessant. During tachycardia long R-P′ intervals, (196±24) ms, were found, and R-P ′/ P′-R ratios were mostly greater than 1 with retrograde Pwaves negative in the inferior leads. Electrophysiologic studies demonstrated all patients with concealed slow conducting accessory pathway for retrograde conduction. At the abl ation sites V-A intervals were (163±22) ms, and decremental conducting properties could be found. Seven accessory pathways were located in right posteroseptal in 4 patients, right midseptal in 1, left posteroseptal in 1 and left posterior in 1. All ablations were successful at the first operation with a mean of (11± 3) min of X-ray time, and without adverse effects. During the follow-up, all patients remained free from tachycardia. Conclusion: PJRT is a special type of atrioventricular reentry tachycardia through concealed slow and decremental conducting accessory pathway. Catheter ablation is an effective and safe curative treatment. |
| Key words: catheter ablation radiofrequency current tachycardia su praventricular electrophysiology |
