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目的 评价程控刺激不能诱发的房室结折返性心动过速 (AVNRT)射频消融慢径的临床疗效。方法 6 1例有心动过速病史且心电图疑诊为AVNRT的病人 ,电生理检查有房室结双径(DAVNP)但不能诱发AVNRT ,随机分为两组。A组 30例不消融而进行临床随访 ,当心动过速复发且经心电图证实为窄QRS心动过速者接受射频消融阻断慢径。B组 31例接受射频消融以阻断慢径 ,术后临床随访。结果 A、B两组分别有 2 4例和 2 7例病人完成随访。A组 2 4例随访中分别在 1年内发作心动过速 ,再次接受消融阻断慢径后随访 (12 .1± 12 .2 )个月 ,仅 1例复发心动过速 (4.2 % ) ,与消融前比较差异有显著性 (P <0 .0 0 0 1)。B组 2 7例平均随访 (2 4 .2± 17.6 )个月 ,1例复发心动过速 (3.7% ) ,与A组病人消融前相比差异有显著性 (P <0 .0 0 0 1) ,而与其消融后比较差异无显著性 (P >0 .0 5 )。结论 有阵发性心动过速病史且心电图疑诊为AVNRT的病人 ,电生理检查有DAVNP而不能诱发心动过速者 ,射频消融阻断慢径具有良好的临床疗效。
Objective To evaluate the clinical effect of program-controlled stimulation on radiofrequency ablation of slow pathway in atrioventricular nodal reentrant tachycardia (AVNRT). Methods Sixteen patients with a history of tachycardia and suspected electrocardiogram AVNRT were examined by electrophysiological examination for AVNRT with AVNRT and were randomly divided into two groups. A group of 30 patients without ablation and clinical follow-up, when the recurrence of tachycardia and ECG confirmed by narrow QRS tachycardia radiofrequency ablation to block the slow pathway. B group 31 patients underwent radiofrequency ablation to block the slow path, postoperative clinical follow-up. Results A total of 24 cases and 27 cases of two groups were followed up. Twenty-four patients in group A underwent follow-up after one-year follow-up (12.1 ± 12.2 months) after ablation, and only one case had recurrent tachycardia (4.2%) There was significant difference before ablation (P <0.0100). In group B, 27 cases were followed up for an average of (24.2 ± 17.6) months and 1 case had recurrent tachycardia (3.7%), which was significantly different from that of group A before ablation (P <0.05 01) ), But there was no significant difference after ablation (P> 0.05). Conclusions There is a history of paroxysmal tachycardia and electrocardiogram suspected of AVNRT patients, electrophysiological examination with DAVNP can not induce tachycardia, radiofrequency ablation of slow pathway has a good clinical effect.