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目的房室结折返性心动过速(AVNRT)患者心内电生理检查中不能诱发心动过速并不少见。经验性慢径改良可作为治疗不可诱发但疑似为AVNRT一种选择,但其长期疗效仍不清楚。方法对2005年1月至2013年12月经电生理检查证实或疑似为AVNRT并行慢径改良的患者进行回顾性随访。根据是否可诱发出与临床相同的室上性心动过速分为可诱发组(A组)和不可诱发组(B组)。对所有患者进行电话随访和/或临床随访。确定复发的依据为经再次手术证实和/或复发心电图和/或典型临床症状。结果一共纳入622例患者(平均年龄为46岁,女性56.8%)。A组488例,B组134例,B组中131例证实存在房室结双径路现象。中位随访时间31个月,总的因室上性心动过速的复发和因其他心律失常的复发分别为16例(2.6%)和32例(5.1%),其中A组和B组因室上性心动过速的复发率分别为2.9%和1.5%(P=0.560),其他心律失常复发率分别为4.5%和7.5%(P=0.170)。A组出现1例房室传导阻滞,B组无并发症。结论长期随访证实经验性慢径改良是治疗不可诱发但疑似为AVNRT一种安全有效的方案。
Atrioventricular nodal reentrant tachycardia (AVNRT) in patients with electrophysiological examination can not induce tachycardia is not uncommon. Experience in slow pathological improvement can be used as an alternative therapy for AVNRT, but its long-term efficacy remains unclear. Methods Retrospective follow-up was performed on patients with pathologically improved slow AVNRT confirmed by electrophysiological examination from January 2005 to December 2013. According to whether it can induce clinically the same supraventricular tachycardia can be divided into induction group (A group) and non-induced group (B group). Telephone follow-up and / or clinical follow-up of all patients. The basis for determining relapse is the re-electrosurgical confirmation and / or relapse of the electrocardiogram and / or typical clinical symptoms. Results A total of 622 patients (mean age 46 years and 56.8% women) were enrolled. 488 cases in group A, 134 cases in group B, and 131 cases in group B confirmed the phenomenon of atrioventricular node dual-pathways. The median follow-up time was 31 months. The total recurrence due to supraventricular tachycardia and other arrhythmias were 16 (2.6%) and 32 (5.1%), respectively, of which A and B The rates of recurrence of supraventricular tachycardia were 2.9% and 1.5%, respectively (P = 0.560). The recurrence rates of other arrhythmias were 4.5% and 7.5%, respectively (P = 0.170). A group of 1 case of atrioventricular block, B group without complications. CONCLUSIONS: Long-term follow-up confirms that experience-based slow pathway improvement is a safe and effective treatment for non-induced but suspected AVNRT.