Hussien Khaled, Hammouda Mohamed, Elakbawy Hazem, Abdelaziz Ahmed, Abdelaal Ahmed, Shehata Mohamed, Abdelkhalik El Shazly, Nagi Hassan, Mokhtar Sherif
Critical Care Department, Faculty of Medicine, Cairo University, Egypt.
J Saudi Heart Assoc. 2009 Oct;21(4):221-8. doi: 10.1016/j.jsha.2009.10.005.
The introduction of technique of radiofrequency (RF) catheter ablation in 1990, has revolutionized management of different types of paroxysmal supraventricular tachycardia (PSVT). In spite of higher success rate, there were reported recurrences among different types of SVT. The aim of this study was to report the efficacy of RF ablation, its complications, recurrence rate and its predictors.
The material of this study (our 3rd registry) included patients who underwent electrophysiological study (EPS) and radiofrequency ablation of their supraventricular tachycardia in the past 5 years, starting from January 2002 to January 2007 at The Critical Care Medicine Department, Cairo University.
Out of 400 pts studied, 381 (95%) had been subjected to radiofrequency ablation (RF) ablation while the remaining 19 pts (4.7%) refused ablation for fear of possible complications. Out of the 381 pts, 366 (96%) had their target tachycardia successfully terminated, from them 26 pts (7%) experienced recurrence after having successful RF ablation. Nine pts (34.6%) of total recurrence was reported in pts with AVNRT, 7 pts (26.9%) of total recurrence was reported in pts with AVRT utilizing septal accessory pathway (Rt AS and /or Rt PS AP), 4 pts (15.4%) was reported in pts with double AP, 2 pts (7.7%) of total recurrence was reported in pts with AFl, one pt (3.8%) of total recurrence was reported in cases of AT. Redo ablation have been carried out successfully in 25 pts (96.2%), and one pt (3.8%) refused ablation for fear of possible complications.
Although electrophysiological study and RF ablation eliminated different types of SVT. However, there may be increased incidence of recurrence among pts with AVNRT and AVRT utilizing concealed septal AP and multiple APs secondary to the complexity of AVN physiology, the critical location of septal AP, the clinical expertise, and poor electrophysiological criteria for good procedural success.
1990年引入的射频（RF）导管消融技术彻底改变了不同类型阵发性室上性心动过速（PSVT）的治疗方式。尽管成功率较高，但不同类型的室上性心动过速仍有复发报道。本研究的目的是报告射频消融的疗效、并发症、复发率及其预测因素。
本研究资料（我们的第三个登记册）包括2002年1月至2007年1月在开罗大学重症医学科过去5年中接受电生理检查（EPS）和室上性心动过速射频消融的患者。
在研究的400例患者中，381例（95%）接受了射频消融，其余19例（4.7%）因担心可能的并发症而拒绝消融。在381例患者中，366例（96%）成功终止了目标心动过速，其中26例（7%）在射频消融成功后复发。房室结折返性心动过速（AVNRT）患者中，9例（34.6%）出现总复发；利用间隔旁道（右前间隔旁道和/或右后间隔旁道）的房室折返性心动过速（AVRT）患者中，7例（26.9%）出现总复发；双旁道患者中，4例（15.4%）出现总复发；房扑患者中，2例（7.7%）出现总复发；房性心动过速患者中，1例（3.8%）出现总复发。25例（96.2%）患者成功进行了再次消融，1例（3.8%）因担心可能的并发症而拒绝消融。
尽管电生理检查和射频消融消除了不同类型的室上性心动过速。然而，由于房室结生理的复杂性、间隔旁道的关键位置、临床专业知识以及良好手术成功的电生理标准不佳，房室结折返性心动过速和利用隐匿性间隔旁道及多条旁道的房室折返性心动过速患者的复发率可能会增加。
