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目的:分析右侧房室旁路射频消融术后复发原因,提高射频消融术的成功率。方法:对1992年1月~2006年12月行射频消融术房室旁路进行回顾性分析,对比分析左、右侧房室旁路及右侧房室旁路中复发组、非复发组的旁路电位、手术时间、X线曝光时间、放电功率、有效消融时间>5 s和多条旁路的发生率。结果:右侧房室旁路的复发率(14/112例,12.5%)明显高于左侧(13/536例,2.43%),P<0.01;右侧房室旁路的手术时间、X线曝光时间和多条旁路的发生率亦均明显高于左侧(P<0.01)。右侧房室旁路患者中,复发组多条旁路的发生率[5例(35.71%)]和有效消融时间超过5 s[10例(71.43%)]的患者均明显多于非复发组[4例(4.08%)、7例(7.14%)],P<0.01,而旁路电位的出现率[28.57%(4例)]却明显低于非复发组[66.32%(65例)],P<0.05。结论:右侧房室旁路射频消融术后复发率高与其解剖部位、定位标测不准及存在多条旁路有关。
Objective: To analyze the causes of recurrence after right atrioventricular bypass radiofrequency ablation and to improve the success rate of radiofrequency ablation. Methods: From January 1992 to December 2006, we performed a retrospective analysis of atrioventricular bypass in radiofrequency catheter ablation. The left and right atrioventricular bypass and right atrioventricular bypass in relapsed group, non-recurrent group Bypass potential, operation time, X-ray exposure time, discharge power, effective ablation time> 5 s and the incidence of multiple bypass. Results: The recurrence rate of the right atrioventricular bypass (14/112 cases, 12.5%) was significantly higher than that of the left (13/536 cases, 2.43%), P <0.01; Line exposure time and the incidence of multiple bypass were also significantly higher than the left (P <0.01). In the right atrioventricular bypass patients, the incidence of multiple bypass in the recurrent group was significantly higher than that in the non-recurrent group (5 cases (35.71%)] and effective ablation time of more than 5 seconds (10 cases [71.43%]) (4 cases, 4.07%), 7 cases (7.14%), P <0.01, while the incidence of bypass potential (28.57%, 4 cases) was significantly lower than 66.32% (65 cases) , P <0.05. CONCLUSIONS: The high recurrence rate after radiofrequency ablation of the right atrioventricular bypass is related to its anatomic location, inaccurate positioning mapping and multiple bypass.