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目的总结国内首批高原地区行射频消融治疗的室上性心动过速(简称室上速)患者的临床及电生理资料,探讨高原地区室上速的电生理特征及手术疗效。方法回顾确诊并行射频消融治疗的首批室上速患者,收集并分析所有患者的临床及电生理检查和射频消融手术资料。结果共收集56例,全部为世居海拔3 000m以上的高原藏族居民,其中男17例,女39例。室上速发作病史(9.26±10.28)年。房室结折返型心动过速(AVNRT)略多于房室折返型心动过速(AVRT)(57.14%和42.86%);男性患者中AVRT是AVNRT的2.4倍(70.6%与29.4%),女性患者中AVNRT是AVRT的2.3倍(69.3%与30.7%),差异有显著性(P=0.003)。AVRT初次发作室上速年龄小于AVNRT[(38.35±18.28)岁vs(47.45±13.97)岁,P=0.04]。AVRT心室刺激诱发成功率显著高于AVNRT(79.2%vs 18.8%,P=0.00),而AVNRT的心房刺激成功率显著高于AVRT(96.9%vs 37.5%,P=0.00);房室旁路与房室结双径路患者的基础AH间期无差异[(78.68±23.24)ms vs(72.06±14.26)ms,P=0.29],但两组患者的HV间期比较,有差异[(43.05±11.65)ms vs(51.54±8.55)ms,P=0.02]。所有患者均成功完成消融手术,无手术相关并发症,随访1~41个月,未见复发病例。结论高原地区室上速患者基础电生理特征无特殊,接受射频消融手术安全有效,应普及推广。
Objective To summarize the clinical and electrophysiological data of patients with supraventricular tachycardia who underwent radiofrequency ablation in the first plateau in China and explore the electrophysiological characteristics and surgical outcomes of supraventricular tachycardia in the plateau. Methods The first batch of patients with supraventricular tachycardia diagnosed with concurrent radiofrequency ablation were retrospectively reviewed, and clinical and electrophysiological examination and radiofrequency ablation data were collected and analyzed. Results A total of 56 cases were collected, all of which were Tibetan Plateau residents above 3,000m above sea level, including 17 males and 39 females. The history of supraventricular tachycardia (9.26 ± 10.28) years. Atrioventricular nodal reentrant tachycardia (AVNRT) slightly more than atrioventricular reentrant tachycardia (AVRT) (57.14% and 42.86%); male patients with AVRT AVNRT 2.4 times (70.6% and 29.4% AVNRT was 2.3-fold (69.3% vs. 30.7%) AVRT in patients with significant difference (P = 0.003). The AVRT initial AVS was less than AVNRT [(38.35 ± 18.28) vs (47.45 ± 13.97) years, P = 0.04]. The success rate of AVRT induced by ventricular stimulation was significantly higher than that of AVNRT (79.2% vs 18.8%, P = 0.00), while the success rate of AVNRT atrial stimulation was significantly higher than that of AVRT (96.9% vs 37.5%, P = 0.00) There was no significant difference in the basic AH interval between two groups (P> 0.79), while the HV interval was significantly different between the two groups (43.05 ± 11.65 ms vs (72.06 ± 14.26) ms, P = 0.29) ) ms vs (51.54 ± 8.55) ms, P = 0.02]. All patients were successfully completed ablation, no complications associated with surgery, followed up for 1 to 41 months, no recurrence of cases. CONCLUSIONS: The basic electrophysiological characteristics of patients with supraventricular tachycardia in plateau are of no special nature. Radiofrequency ablation is safe and effective and should be popularized.