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为评价射频导管消融改良房室结慢径路的两种方法,对连续42例房室结内折返性心动过速患者分别采用下位法和后位法进行慢径路改良。结果总成功率97.6％,并发症率2.4％。认为;(1)下位法比后位法明显有效,但发生完全性心脏传导阻滞的危险性亦增加;(2)建议对年轻者(如≤55岁)优先采用后位法,对年长者可径用下位法,必要时可在消融电极心电图上保留较小的希氏束电位放电;(3)采用下位法时必须先以消融电极稳定记录到明确的希氏束电位后,再向下弯曲导管,以提高定位慢径路的准确性和减少心脏传导阻滞的发生;(4)放电中出现与窦性心律竞争的房室交接区性心律现象揭示消融有效,而出现房室交接区性心动过速则提示可能发生完全性传导阻滞。
In order to evaluate the two methods of radiofrequency catheter ablation for atrioventricular nodal slow pathway, 42 consecutive patients with atrioventricular nodal reentrant tachycardia were treated with the inferior and posterior methods for slow pathway improvement. Results The total success rate of 97.6%, the complication rate of 2.4%. (2) It is suggested that the younger person (eg, ≤55 years old) should be given priority to the postpositional method, to the elderly Can diameter with the next method, if necessary, can be retained in the ablation electrode ECG small His bundle potential discharge; (3) the use of the lower method must first ablation electrodes stable record of a specific His bundle potential, and then to Under the curved catheter to improve the accuracy of positioning the slow pathway and reduce the incidence of heart block; (4) appear in the discharge and sinus rhythm of atrioventricular junctional regional rhythm revealed ablation effective, and the emergence of atrioventricular junction area Tachycardia may suggest complete conduction block.