CAJ | 학술논문

目的观察无A-H 间期跳跃和不能诱发的房室结折返性心动过速（AVNRT）慢径路消融特点和远期疗效。方法经电生理检查证实无旁道参与的阵发性室上性心动过速患者100例，分成三组：能诱发AVNRT，有明显跳跃（A 组，n=40）；不能诱发AVNRT，但有A-H间期＞50ms 的明显跳跃（B组，n=40）；不能诱发AVNRT 且没有A-H 间期＞50ms 的明显跳跃（C 组，n=20）。比较术后各组电生理数值及消融远期疗效。结果与消融术前相比，术后各组患者的房室结顺传文氏周期均延长（P＜0.05）；消融术后房室结顺传有效不应期较术前缩短，差异有统计学意义（P＜0.05）；三组均出现缓慢交接区心律。术后随访12个月，各组复发率差异无统计学意义（P＞0.05）。结论无A-H 间期跳跃且程控刺激不能诱发的AVNRT 的慢径路消融是安全有效的。缓慢交接区心律是消融有效的标志。
목적관찰무A-H 간기도약화불능유발적방실결절반성심동과속（AVNRT）만경로소융특점화원기료효。방법경전생리검사증실무방도삼여적진발성실상성심동과속환자100례，분성삼조：능유발AVNRT，유명현도약（A 조，n=40）；불능유발AVNRT，단유A-H간기＞50ms 적명현도약（B조，n=40）；불능유발AVNRT 차몰유A-H 간기＞50ms 적명현도약（C 조，n=20）。비교술후각조전생리수치급소융원기료효。결과여소융술전상비，술후각조환자적방실결순전문씨주기균연장（P＜0.05）；소융술후방실결순전유효불응기교술전축단，차이유통계학의의（P＜0.05）；삼조균출현완만교접구심률。술후수방12개월，각조복발솔차이무통계학의의（P＞0.05）。결론무A-H 간기도약차정공자격불능유발적AVNRT 적만경로소융시안전유효적。완만교접구심률시소융유효적표지。
Objective To assess features of slow pathway ablation and long-term efficacy of atrioventricular nodal reentrant tachycardia(AVNRT) without AH jump and tachycardia onset during programmed stimulation. Methods Based on electrophysiological test results, 100 patients with paroxysmal supraventricular tachycardia and no bypass pathway were divided into group A, AH jump followed by AVNRT onset(n=40), group B, AH jump but no AVNRT(n=40 ), and group C, no AH jump and no ANVRT (n=20). Electrophysiological parameters and long-term efficacy were compared between groups. Results AV nodal antegrade conduction Wenckebach periods were prolonged significantly in all patients after ablation(P<0.05). The effective refractory period of AV node shortened significantly after ablation(P<0.05). Junctional rhythmappeared during ablation in all patients. The recurrence rate was similar in all groups during follow-up 12 months. Conclusion Slow pathway ablation is safe and effective for AVNRT without AH jump and inducible tachycardia during programmed stimulation. Junctional rhythmis a marker of effective ablation.