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目的 研究心脏电生理指标在普通型房室结折返性心动过速 (AVNRT)慢径消融前 ,预测消融后房室传导阻滞 (A BV)发生的可能性。方法 10 9例普通型AVNRT病人依消融过程中出现交界性心动过速 (JT)、无室房传导的JT及随后A VB发生与否分为 3组 :①无室房传导JT和随后A VB组 (组 1,16例次 ) ;②无室房传导JT而无A VB组 (组 2 ,2 6例次 ) ;③单纯JT组 (组 3 ,38例次 )。比较以下参数 :①His束A波至消融电极远端A波间期 [A(H) -A(Md) ] ;②His束A波至冠状窦口A波间期 [A(H) -A(CS) ] ;③消融靶点A V比值 ;④慢径电位 ;⑤碎裂心房波 ;⑥室房阻滞前JT周长。结果 组 1的A(H) -A(Md)间期明显短于组 2和组 3(16± 9.2msvs 34± 9.8ms ,30± 12 .4ms ,P <0 .0 5 ) ,而A(H) -A(CS)、A V比值、慢径电位、碎裂心房波及室房阻滞前JT周长与消融过程中是否发生A VB无关。结论 A(H) -A(Md)间期反映了消融电极头部与His为标记的房室结之间的距离 ,该间期越短 ,消融中发生A VB的可能性越大
Objective To investigate the potential of cardiac electrophysiology to predict the occurrence of atrioventricular block (ABV) after atrial ablation of atrioventricular nodal reentrant tachycardia (AVNRT). Methods Ninety-nine patients with common type AVNRT underwent borderline tachycardia (JT) during ablation, without conduction of JT and subsequent VBV. The patients were divided into three groups: ① without conduction of JT and then with VB Group (group 1, 16 cases). ② There was no room conduction JT without A VB group (group 2, 26 cases); ③ Simple JT group (group 3, 38 cases). The following parameters were compared: ① A wave interval between A wave and A wave to A wave interval [A (H) -A (Md)]; )]; ③ ablation target AV ratio; ④ slow pathway potential; ⑤ fragmented atrial wave; Results The A (H) -A (Md) interval of group 1 was significantly shorter than that of group 2 and group 3 (16 ± 9.2 ms vs 34 ± 9.8 ms, 30 ± 12.4 ms, P <0.05) H) -A (CS), AV ratio, slow pathway potential, atrial fibrillation and ventricular block before JT circumference and ablation is not related to the occurrence of A VB. Conclusion The interval A (H) -A (Md) reflects the distance between the ablation electrode tip and His labeled atrioventricular node. The shorter the interval, the greater the possibility of ABV ablation