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目的 :探讨呈非跳跃性房室结功能曲线 (AVNFC)的房室结折返性心动过速 (AVNRT)射频消融成功的电生理特点。方法 :将 75例AVNRT患者分为 3组 :A组 16例 ,心房递增起搏和A1A2 程序刺激均呈非跳跃性AVNFC ;B组 10例 ,仅心房递增起搏呈跳跃性AVNFC ;C组 4 9例 ,心房递增起搏和A1A2 程序刺激均呈跳跃性AVNFC。比较 3组患者射频消融前后组内及组间的电生理参数。结果 :消融后 3组患者心房递增起搏时最大AH间期 (A1H1max)均比消融前显著缩短 (P <0 .0 5 )。A组消融前、后A1H1max的缩短程度均小于B组和C组 (P <0 .0 5 )。A组非典型AVNRT的诱发率明显高于B组和C组。结论 :对于心房递增起搏和A1A2 程序刺激均呈非跳跃性AVNFC的AVNRT患者 ,消融后A1H1max的显著缩短可作为消融成功的指标之一。AVNFC呈非跳跃性的房室结双径路患者易诱发非典型AVNRT。
Objective: To investigate the electrophysiological characteristics of atrioventricular nodal reentrant tachycardia (AVNRT) radiofrequency ablation with non-skip AVNFC. Methods: A total of 75 AVNRT patients were divided into 3 groups: group A (n = 16), atrial pacing (AVNFC) and A1A2 stimulation 9 cases, atrial pacing increased and A1A2 program showed a jump in AVNFC. The electrophysiological parameters of the three groups before and after radiofrequency ablation were compared between groups. Results: After ablation, the maximal AH interval (A1H1max) in the atrial pacing group was significantly shorter than that before ablation (P <0.05). The shortening of A1H1max before and after ablation in group A was less than those in group B and C (P <0.05). A group of atypical AVNRT induced rate was significantly higher than the B group and C group. CONCLUSIONS: A shortening of A1H1max after ablation for AVNRT patients with non-skip AVNFC stimulated by atrial pacing and A1A2 stimulation may be one of the successful ablation indications. Patients with AVNFC who have a non-jumpy AVNR tend to induce atypical AVNRT.