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房室结折返性心动过速导管消融术后七年随访

Seven-year follow-up after catheter ablation of atrioventricular nodal re-entrant tachycardia.

作者信息

Maggi Roberto, Quartieri Fabio, Donateo Paolo, Bottoni Nicola, Solano Alberto, Lolli Gino, Tomasi Corrado, Croci Francesco, Oddone Daniele, Puggioni Enrico, Menozzi Carlo, Brignole Michele

机构信息

Arrhythmologic Centre, Department of Cardiology, Ospedali del Tigullio, Lavagna, Italy.

出版信息

J Cardiovasc Med (Hagerstown). 2006 Jan;7(1):39-44. doi: 10.2459/01.JCM.0000199784.56642.f7.

Abstract

BACKGROUND

Radiofrequency catheter ablation is considered to be a curative therapy for patients with atrioventricular nodal re-entrant tachycardia (AVNRT). Nevertheless, there is little information available with respect to long-term results and the consequences of catheter ablation. The present study aimed to assess the long-term results (a minimum of 5 years) and clinical events.

PATIENTS AND METHODS

The recurrence rate of AVNRT, the development of late atrioventricular block and the presence of other arrhythmias (atrial flutter and fibrillation) were assessed in 131 consecutive patients who were undergoing catheter ablation between January 1992 and December 1998.

RESULTS

During a mean follow-up of 7.2 +/- 2.5 years, tachycardia recurred in 13 patients (10%) after a median time of 6 months (interquartile range 4-24 months) and a second procedure was perfomed. Atrioventricular block occurred in two patients (1.5%) after 1 and 13 months. Atrial fibrillation recurred in seven (44%) of 16 patients in whom atrial fibrillation or flutter was present before ablation after a median of 12 months (interquartile range 9-15 months). Overall, all these events occurred after a median of 9 months (interquartile range 4-17 months). Subsequently, no event related to the arrhythmia or to the procedure was observed. A new onset atrial fibrillation, probably not related to AVNRT, occurred late in the follow-up in a further three patients.

CONCLUSIONS

Arrhythmic events are not infrequent after catheter ablation of AVNRT during the early years after ablation, but they are unlikely during the subsequent long-term follow-up.

摘要

背景

射频导管消融术被认为是房室结折返性心动过速(AVNRT)患者的一种治愈性疗法。然而,关于长期疗效和导管消融后果的信息却很少。本研究旨在评估长期疗效(至少5年)及临床事件。

患者与方法

对1992年1月至1998年12月期间连续接受导管消融术的131例患者,评估AVNRT的复发率、晚期房室传导阻滞的发生情况以及其他心律失常(心房扑动和颤动)的存在情况。

结果

在平均7.2±2.5年的随访期间,13例患者(10%)在中位时间6个月(四分位间距4 - 24个月)后心动过速复发,并进行了第二次手术。2例患者(1.5%)在1个月和13个月后发生房室传导阻滞。16例消融术前存在心房颤动或扑动的患者中,7例(44%)在中位时间12个月(四分位间距9 - 15个月)后心房颤动复发。总体而言,所有这些事件均在中位时间9个月(四分位间距4 - 17个月)后发生。随后,未观察到与心律失常或手术相关的事件。在随访后期,又有3例患者出现新发心房颤动,可能与AVNRT无关。

结论

AVNRT导管消融术后早期心律失常事件并不少见,但在随后的长期随访中不太可能发生。

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