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目的:探讨伴RR间期交替的窄QRS波心动过速的电生理机制和射频消融策略。方法:10例伴RR间期交替的心动过速患者接受了电生理检查,明确其心动过速类型后,首先消融旁路或诱发的心动过速,如仍能诱发房室结折返性心动过速(AVNRT)则消融慢径路,并随访了解心动过速复发情况。结果:10例患者中9例为左侧游离壁旁路合并房室结双径路,消融旁路后3例诱发AVNRT,一并成功消融了慢径路,另6例没有诱发AVNRT者未再消融,1例为房室结三径路,成功消融了慢径路。在6个月～8.4年随访中,无心动过速复发。结论:伴RR间期交替的心动过速具共同特点,即存在房室结双径路。在消融基础心动过速后,如不能诱发AVN-RT,可不消融慢径路。
Objective: To explore the electrophysiological mechanism and radiofrequency ablation strategy of narrow QRS tachycardia with RR interval alternation. Methods: Ten patients with RR interval alternating tachycardia received electrophysiological examination. After the type of tachycardia was clearly identified, they were firstly ablated or induced tachycardia. If still can induce atrioventricular nodal reentrant cardioversion (AVNRT) ablation of slow pathway, and follow-up to understand the recurrence of tachycardia. Results: Among the 10 patients, 9 cases were left bypass wall combined with AVNRT. After AVNRT, AVNRT was induced in 3 cases and slow pathway was ablated in 6 cases. AVNRT was not ablated in 6 cases, 1 case of atrioventricular node three pathways, successful ablation of slow path. In 6 months to 8.4 years of follow-up, no recurrent tachycardia. CONCLUSION: Tachycardia with RR interval alternation has the common feature that there is atrioventricular node dual pathway. In the ablation basal tachycardia, such as can not induce AVN-RT, can not ablate slow pathway.