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Comparative Analysis of Radiofrequency Ablation Effects of AVRT and AVNRT<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
于波 赵卫华 胡健 白小涓 曾定尹 李敏
于雅媛 郭英 李玉红 李阳 关付 齐国先
中国医科大学第一医院循环内科, 沈阳 110001
Bo Yu, Wei-hua Zhao, Jian Hu, Xiao-juan Bai, Din-ying Zeng, Ya-yuan Yu, Min Li, Ying Guo,
Yu-hong Li, Yang Li，Fu Guan, Guo-xian Qi
Cardiovascular Department, No.1 Hospital, China Medical University, Shenyang 110001
ABSTRACT
Objective: Retrospectively comparative analysis of clinical effects and complications of atrioventricular reentrant tachycardia(AVRT ) and atrioventricular node reentrant tachycardia(AVNRT) by radiofrequency ablation therapy to further increase the success rate and decrease the complications.
Method: Electrode catheters were sent to coronary sinus, right atrium, right ventricle, and his bundle through puncture of the left clavicular vein and right femoral vein. Programmed stimulus were delivered to right atrium, right ventricle to induce tachycardia and to clarify the mechanism of the tachycardia. The patients diagnosed by cardiac electrophysiology as AVNRT were 200, male 93, female107, age 14-78years(average 45.3±15.1). The patients diagnosed by as AVRT were 445, left accessory pathway 331, right accessory pathway 96, double accessory pathway 13, triple accessory pathway 2, slow accessory pathway 3. Radiofrequency ablation therapy was delivered by Webster or Daig temperature-controled ablation catheters. The patients were followed up by phone or outpatient department examination for 12.5±10.2 months for the complications and recurrence rate.
Results: The success rate for AVNRT was 96.5%, recurrence rate was 2.5%, and all recurrent patients were success by another ablation therapy. The complications rate was 0.5%, including 1 patient with complete atrioventricular block (a permanent pacemaker was implanted) , 1 patients with permanent I degree atrioventricular block. The success rate for left accessory pathway was 95.8%, 14 patients were failure. The recurrence rate was 2.1%. The complications rate was 0.91%, including 1 patient with acute cardiac tamponade, 1 patient died during operation, 1 patients died after 24 hours of the operation. The success rate for right accessory pathway was 89.58%, the recurrence rate was 3.13%, no complications. The success rate for more than one accessory pathway and slow accessory pathway were 93.4% and 100%, no complications.
Conclusions: The success rate for AVNRT and left side AVRT were relatively high, and that for right side AVRT were relatively lower. The complication rate and recurrence rate for AVNRT and AVRT were quite lower. This suggested that radiofrequency ablation treatment for AVNRT and AVRT was a safe and an effective method. Further catheter improvement and technique enhancement was necessary to cure the patients with right side accessory pathway.
Key words: Radiofrequency ablation; AVNRT; AVRT
射频消融治疗各种快速性室上性心律失常临床应用十余年，已经成为治疗各种快速性室上性和室性心律失常的首选手段。本文回顾性随访分析我院采用射频消融方法治疗的房室结折返性心动过速(AVNRT)和房室折返性心动过速(AVRT)病人的临床疗效和并发症发生情况，以进一步提高对AVNRT和AVRT两种心动过速的认识和射频消融诊治水平。
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