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目的观察性研究房室结折返性心动过速(atrioventricular nodal reentrant tachycardia,AVNRT)合并心房颤动(atrial fibibrillation,AF)患者行慢径改良术的有效性。方法连续入选402例AVNRT患者,电生理检查或术中发生阵发性心房颤动者,仍行房室结慢径改良术。以不能诱发心动过速和房颤为手术终点。结果 8例患者在消融前的电生理检查过程中房室结折返性心动过速发作后直接转为心房颤动,5例自动转复为房室结折返性心动过速,3例直接转复窦性心律。2例患者进行慢径改良时出现心房颤动,继续消融后心房颤动终止。随访2年,有1例患者心房颤动复发。结论房室结折返性心动过速合并房颤,行慢径改良术后,以不能诱发心动过速及房颤发作为手术终点,是有效的,可不行房颤消融术。
Objective To observe the effectiveness of slow pathway modification in patients with atrioventricular nodal reentrant tachycardia (AVNRT) and atrial fibrillation (AF). Methods A total of 402 patients with AVNRT were enrolled in this study. Electrophysiology or intraoperative paroxysmal atrial fibrillation were performed. Can not induce tachycardia and atrial fibrillation for the end of surgery. Results Eight patients were directly converted to atrial fibrillation after the onset of atrioventricular nodal reentrant tachycardia in the electrophysiological examination before ablation, 5 cases were automatically converted to atrioventricular nodal reentrant tachycardia, and 3 cases were directly converted to sinus rhythm Sexual rhythm. Atrial fibrillation was observed in 2 patients with slow pathway improvement and atrial fibrillation was terminated after ablation. After 2 years of follow-up, 1 patient had atrial fibrillation recurrence. Conclusions Atrioventricular nodal reentrant tachycardia combined with atrial fibrillation is an effective method for atrial fibrillation after ameliorating slow pathway. It is effective to not induce tachycardia and atrial fibrillation.