【摘要】 报道８例快－慢型房室结折返性心动过速（ＡＶＮＲＴ）的电生理特征及射频消融治疗。其中３例为慢－快型ＡＶＮ－ＲＴ射频消融改良慢径后出现的快－慢型ＡＶＮＲＴ。８例均经消融慢径而成功终止心动过速。平均放电次数３±１．１次、平均放电时间１２０±３０．４ｓ、平均放电功率３０±１１Ｗ。随访６～２４个月，无复发。快－慢型ＡＶＮＲＴ具有以下临床电生理特征：①快径不应期短、慢径不应期长。②心内电刺激无房室结双径路现象。③心动过速能由心房刺激诱发。④心动过速时ＡＨ间期＜ＨＡ间期，冠状窦近端Ａ波最提前。熟悉快－慢型ＡＶＮＲＴ的电生理特征，对于鉴别房性心动过速及右后间隔旁道参与的房室折返性心动过速十分重要，也是指导快－慢型ＡＶＮＲＴ射频消融成功的关键。更多还原

【Abstract】 Eight patients with atypical atrioventricuar nodal reentrant tachycardia(AVNRT) were treated by radiofrequency catheter ablation slow pathway.Among them,there were 3 patients who initially showed typical AVNRT,and reverted to atypical AVNRT after ablation.It was effective to deliver additional radiofrequency energy to the same sites.The number,the time and the engergy of ablation were mean 3±1 1 times,120±30 4 seconds,30±11 walts,respectively.No one recurred after 6～24 months follow up.The clinical features of atypical AVNRT were as follows:(1)The effective refractory peroid of fast pathway was shorter than that of slow pathway.(2)No dual atrioventricular nodal pathways during intracardiac electrical stimuli.(3)Atypical AVNRT could be induced by stimulating high right atrium.(4)AH interval was less than HA,and A wave was the earliest at the proximal coronary sinus during tachycardia.We think it is necessary to understand the electrophysiological features of atypical AVNRT by which we could differentiate it and atrial tachycardia,atrioventricular reentrant tachycardia due to posteroseptal accessory pathway.It is key to ablate successfully.更多还原