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目的:观察房室结折返性心动过速(AVNRT)的慢径消融终点与复发的联系。方法:534个慢-快型AVNRT患者行慢径消融治疗,观察A型终点(彻底消融慢径,房室结无跳无折)和B型终点(残留慢径有或无1～3心房回波,不能诱发AVNRT)与AVNRT复发的联系及对房室结传导的影响。结果:①A型复发5例(1.2%),B型复发11例(9.4%),差异有统计学意义(P<0.05)。②A型终点房室结前传文氏周期(Wen-AVN)、快径前传有效不应期和房室结双径路(DAVNP)的跳跃增值缩短,B型快径前传有效不应期和房室结双径路的跳跃增值缩短,A型有效不应期的缩短明显大于B型。结论:A型终点的复发率明显低于B型终点;只要改变房室传导功能,不能诱发心动过速,B型终点仍然是有效、可靠的消融终点。
Objective: To observe the relationship between the slow pathway ablation endpoint and recurrence of atrioventricular nodal reentrant tachycardia (AVNRT). Methods: 534 patients with slow-fast AVNRT underwent slow-pathway ablation. The endpoints of type A (complete ablation of slow pathway, non-jump of atrioventricular node) and type B end point (residual slow pathway with or without 1 ~ 3 atria Wave, can not induce AVNRT) and the recurrence of AVNRT and the impact on atrioventricular node conduction. Results: ①A type recurrence in 5 cases (1.2%), B type recurrence in 11 cases (9.4%), the difference was statistically significant (P <0.05). ② Type A end-to-end antrioventricular node Wen-AVN, fast anterior refractory effective refractory period and atrioventricular node dual-pathway (DAVNP) jump shortening value, type B fast anterior refractory effective refractory period and atrioventricular node Double path jump value-added shortening, A-type effective refractory period was significantly shorter than the B-type. Conclusion: The recurrence rate of type A end point is significantly lower than that of type B end point. As long as the change of atrioventricular conduction function can not induce tachycardia, type B end point is still an effective and reliable end point of ablation.