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房室结双径路合并房室旁路的折返性心动过速及射频消融治疗 |
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Reentrant tachycardia and radiofrequency ablation of dual
atrioventricular nodal pathways with atrioventricular accessory pathways
盛晓东 刘志华 宋建平 惠杰 汪康平 蒋文平
Sheng Xiaodong, Liu Zhihua, Song Jianping, et al
【摘要】 目的 本研究旨在探讨房室结双径路(DAVNP)合并房室旁路(AP)的电生
理特征和射频消融要求。方法 对218例阵发性室上性心动过速(PSVT)进行电生理
检查，观察PSVT的前传和逆传途径，然后对AP或房室结慢径(SP)进行消融治疗。结
果 218例PSVT中检出DAVNP+AP 10例，检出率为4.6%。其中SP前传、AP逆传(SP-AP
折返)4例，快径(FP)前传、AP逆传(FP-AP折返)1例，SP-AP折返并FP-AP折返或SP/FP
交替前传折返4例，SP前传、FP逆传(AP旁观)1例。10例患者均作AP消融，诱发房室
结折返性心动过速(AVNRT)的3例加作SP消融，术后随访均无复发。结论 DAVNP合
并AP者AP均作为逆传途径，阻断AP是消融关键；AP旁观者也应作AP消融；仅有AH跳
跃延长者不必接受房室结改良；AP消融者应作DAVNP电生理检查。
【关键词】 心动过速，室上性 电生理学 导管消融术
Reentrant tachycardia and radiofrequency ablation of dual atrioventricular nodal pathways
with atrioventricular accessory pathways Sheng Xiaodong, Liu Zhihua, Song Jianping, et al. The
First Affliated Hospital of Suzhou Medical College, Suzhou 215006
【Abstract】 Objective To examine the electrophysiologic characteristics of dual atrioventricular
nodal pathways (DAVNP) with accessory pathways (AP) and evaluate the criteria for radiofrequency
catheter ablation. Methods Electrophysiologic study were performed on 218 patients with paroxysmal
supraventricular tachycardia (PSVT). The antegrade and retrograde conduction pathways were examined,
and the AP or slow pathway (SP) was ablated if necessary. Results Among the 218 patients with PSVT,
10 patients (4.6%) with DAVNP and AP were found. Of the 10 patients, the reentrant pattern with
antegrade conduction by SP and retrograde conduction by AP was induced in 4 patients, the pattern
with antegrade conduction by fast pathway (FP) in one patient. Four patients manifested antegrade
conduction by SP or FP alternatively, and the last one had SP and FP reentry (AP as a bystander).
Radiofrequency ablation of AP was performed on all[1] [2] [3] 下一页
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