【摘要】 目的:探讨房室折返性心动过速(AVRT)合并房室结双径路(AVNDP)的电生理特征和射频消融术式的选择。方法:对640例阵发性室上性心动过速(PSVT)进行电生理检查,观察PSVT发作时传导的顺序,然后进行消融治疗。结果:640例PSVT中检出AVRT+AVNDP 68例,检出率为10.6%;有8例诱发房室结折返性心动过速,对此类患者进行慢径消融治疗。随访所有经治患者均无复发。结论:AVRT合并AVNDP者阻断房室旁道是消融成功的关键;房室旁道作为"旁观者"时也应作房室旁道消融;如仅有(AH)跳跃但无心动过速者无需接受房室结改良。更多还原

【Abstract】 Objective:To examine the electrophysiological characteristics of atrioventricular reentrant tachycardia(AVRT)with atrioventricular nodal dual pathways(AVNDP)and evaluate the criteria for radiofrequeney catheter ablation.Methods:Electro- physiological study was performed in 640 patients with paroxysmal supraventricular tachycardia(PSVT).The antegrade and retrograde conduction pathways were examined,and the atrioventricular pathway or slow pathway(SP)was ablated if necessa- ry.Results:Among the 640 patients with PSVT,68 patients(10.6%)with DAVNP and AVRT were found.Of the 8 pa- tients,the reentrant pattern with antegrade conduction by SP and atrioventricular nodal reentrant tachycardia(AVNRT)was induced.Radiofrequency ablation of AVRT was performed on all patients and ablation of SP was performed on 8 patients with the initiation of AVNRT.No recurrence was found during follow-up,Conclusion:It is crucial to break the conduction of atrio- ventrieular pathway(AP)in patients with AVRT and AVNDP.The bystander AP should he ablated also.It seems unnecessary to modify the AVN if patients only with the AH jump and no AVNRT.更多还原