RFCA治疗快速性心律失常1 268例临床分析.docVIP

RFCA治疗快速性心律失常1 268例临床分析 作者：丁超 何振山 李俊峡 崔俊玉 于富军 齐书英 李洁 杨丽 【摘要】 目的 分析 总结 经导管射频消融(RFCA) 治疗 快速性心律失常的疗效，以进一步指导临床工作。方法 对我科开展射频消融治疗快速性心律失常16年的工作进行总结，对1 268例患者的治疗结果进行回顾性分析。结果 房室折返性心动过速(AVRT) 患者682例，计有旁道691条，其中左侧旁道542例，右侧旁道140例，其中双旁道9例，房室结双径路合并房室旁道12例。房室结折返性心动过速(AVNRT)453例。室性心动过速和室性早搏62例，房性心动过速18例，心房扑动17例，心房颤动36例。射频消融总成功率为97.5%，其中房室结双径路和左侧房室旁道介导的阵发性室上速射频消融成功率高达99.8%。射频消融术后复发率为2.4%。并发症发生率为0.79 %，其中2例患者并发永久性III°房室传导阻滞而安置永久性心脏起搏器。结论 射频消融治疗快速性心律失常安全、有效、成功率高、并发症发生率低。适合于各类人群, 以AVRT和AVNRT的效果最佳。 【关键词】 射频消融； 心动过速； 并发症 【Abstract】 Objective To analyze the clinical therapeutic experience of radiofrequency catheter ablation (RFCA) and provide　guidelines for further clinical work. Methods The clinical efficacy of RFCA for 1 268 patients with tachyarrhythmia was retrospectively analyzed in our hospital for 16 years. Results There were 682 cases of atrioventricular reentrant tachycardias (AVRT) with 691 accessory pathways,including 542 left accessory pathways,140 right accessory pathways,9 doubleaccessory pathways,and 12 accessory pathways concomitant with dual atrioventricular nodes.There were 453 cases of atrioventricular nodal reentrant tachycardia (AVNRT).In addition, there were 62 cases of ventricular tachyarrhythmia,18 cases of atrial tachycardia (AT)，17 cases of atrial flutter (AFL) and 36 cases of atrial fibrillation (AF).The overall success rate was 97.5%,in which RFCA of supraventricular tachycardias mediated by dual atrioventricular nodes and leftsided accessory pathway had an high success rate (99.8%),whereas the success rate of atrial tachyarrhythmias ablation was the lowest. The recurrence rate after RFCA was 2.4%(31/1268).The incidence rate of complications was 0.79% (10/1268).Permanent cardiac pacemakers were implanted in 2 patients with III degree atrialventricular block after RFCA.Conclusion RFCA can be performed effectively and safely in patients with tachyarrhythmia,especially in patients with AVRT and AVNRT. 【Key words】 Radiofrequency ablation；Tachyarrhythmia