【摘要】 目的　探讨施放射频能量后出现连续性交界性逸搏心律时行间歇右心房起搏下放电的可行性及安全性。方法　 132例房室结折返性心动过速 (AVNRT)患者接受慢径消融治疗 ,其中 2 6例在放电后出现连续性交界性逸搏心律 (频率 65～ 97bpm ,持续时间 >10s) ;射频消融 (RFCA)在间歇性右心房起搏 (频率较交界性心率快 2 0bpm )下进行 ,出现AV延长或AV分离则立即停止放电。另 10 6例RFCA时出现交界性早搏或短阵性交界节律 (<10s) ,故采用“滴定法”放电。结果　① 132例AVNRT均消融成功 ;②右房起搏组放电次数及手术时间较滴定法放电组减少 (P <0 .0 1) ;③起搏下放电组无Ⅲ°房室传导阻滞 (Ⅲ°AVB)等并发症 ,滴定放电组 3例出现一过性Ⅱ°Ⅱ型伴Ⅲ°AVB。结论　对放电后出现持续交界性逸搏心律者在间歇性右心房起搏下放电较安全可靠 ,并不增加房室传导系统的损伤更多还原

【Abstract】 Objective To detect the way of treatment inpatients with atrioventricular nodal reentrant tachycardia by radiofrequency ablation with atrum-pacing.Method 132 patients with atrioventricular nodal reentry (AVNRT)were treated with slow pathway ablation by radiofrequency catheter(RFCA). Continuous junctional escape rhythm(65～97 bpm)was observed in 26 patients,we gave them RFCA with right atrium-pacing(80～110 bpm). The others were given radiofrequency energy without pacing.Results ①All the patients were treated successfully by RFCA. ②The duration and timesof given energy of the patients with atrium-pacing was shorter than the others(68.3±51.7 vs 104.6±69.3 P <0.01,and 1.5±1.4 vs 3.7±2.3 P <0.05).③There was no the third degree atrioventricular block(Ⅲ°AVB) in the patients with atrium-pacing but 3 of 106 was fund in the patients without pacing.Conclusion This study suggests that RFCA with atrium-pacing is a way with safety and simple in the patients with continuous junctional escape rhythm after given energy.更多还原