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25例房性心动过速的电生理检查和射频消融结果 |
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马坚 王方正 余培桢 王锦志 许斐 张奎俊 李一石
华伟 楚建民 方丕华 陈柯平 孙瑞龙 陈新
【摘要】 目的 探讨房性心动过速（房速）的发生机制和射频消融结果。方法 对25例房速患者进行心内电生理检查、药物试验和射频消融治疗。结果 （1）24例阵发性房速为折返机制，并且静脉注射三磷酸腺苷的终止率达87％；而另1例慢性房速则是异常自律性增加。（2）24例（96％）房速消融成功。成功靶点的A波较体表心电图P′波（A-P′间期）提前38±11ms，明显长于非成功靶点（26±7ms，P<0.05）。消融成功部位主要位于房内特殊的解剖区域。结论 成年人阵发性房速的主要发病机制是折返性，并对三磷酸腺苷敏感。射频消融术是治愈房速的有效方法。
【关键词】 心动过速，异位房性 电生理学 导管消融术
The results of electrophysiologic study and radiofrequency ablation in 25 patients with atrial tachycardia Ma Jian, Wang Fangzheng, Yu Peizhen, et al. Department of Clinical Electrophysiology, Fu Wai Hospital, Chinese Academy of Medical sciences, Beijing 100037
【Abstract】 Objective To investigate the mechanism of atrial tachycardia (AT) and the results of radiofrequency ablation. Methods Electrophysiologic study, drug test and radiofrequency ablation were performed in 25 patients with AT. Results It was showed that (1) in 24 patients, the suspected mechanism of paroxysmal AT was related to reentry, and 87% of these AT could be terminated by intravenous adenosine triphosphate (ATP); however the chronic AT in other 1 case was probably due to abnormal automaticity. (2) ATs were successfully ablated in 24 patients (96%). The intervals between the onset of local atrial wave and the P′ wave in surface electrocardiogram (A-P′ interval) were 38±11ms at successful target sites which were mainly located in the special anatomic areas of atria, and were significantly longer than those at unsuccessful ablation sites (26±7ms, P<0.05). Conclusion It is suggested that the major mechanism of AT in adult patients is reentry, and these reentrant AT is adenosine sensitive. Radiofrequency ablation has shown to be an effective method to treat the AT.
【Key words】 tachycardia, ectopic atrial electrophysiology catheter ablation
作为房性心动过速（简称房速）的根治方法之一，射频消融术具有成功率高和并发症低等特点［1～3］。本文总结我院治疗的25[1] [2] 下一页
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