Wang L, Hu D, Ding Y
Department of Cardiology, First Teaching Hospital, Beijing Medical University, China.
Int J Cardiol. 1994 Feb;43(2):185-90. doi: 10.1016/0167-5273(94)90007-8.
A total of 208 atrioventricular (AV) accessory pathways in 200 patients were abolished by catheter radiofrequency current ablation. The antegrade AV conduction was normal after the ablation. Approximately 66% of the patients experienced retrograde AV conduction dissociation, which is independent of the age, gender and antegrade conduction properties of accessory pathways (manifest or concealed). Retrograde conduction dissociation is more prevalent than decremental conduction in patients with left free (80% vs. 17%, P < 0.001) or right free (78.6% vs. 21.4%, P < 0.01) wall pathways. Eleven patients (5.5%) showed recurrence after an average of 213 days follow-up. The recurrence of right free wall pathways (21.4%) is much more common than that of left free wall (2.5%) and posteroseptal (4.8%) pathways. The recurrence in those with decremental conduction after the initial successful ablation is higher than that of patients with retrograde AV dissociation (8.8% vs. 3.8%, P < 0.01), and most of them required a second ablation session.
most of the patients, especially those with free wall accessory pathways, will have retrograde conduction dissociation after the successful radiofrequency catheter ablation. Electrophysiological studies should be carefully performed on patients with decremental retrograde conduction after the ablation.
200例患者共208条房室（AV）旁路通过导管射频电流消融被消除。消融后房室前传正常。约66%的患者出现房室逆传分离，这与旁路的年龄、性别及前传传导特性（显性或隐匿性）无关。左游离壁（80%对17%，P<0.001）或右游离壁（78.6%对21.4%，P<0.01）旁路患者中，逆传分离比递减传导更常见。11例患者（5.5%）在平均213天随访后复发。右游离壁旁路的复发（21.4%）比左游离壁（2.5%）和后间隔（4.8%）旁路更常见。初次成功消融后有递减传导的患者复发率高于有房室逆传分离的患者（8.8%对3.8%，P<0.01），且大多数患者需要再次消融。
大多数患者，尤其是有游离壁旁路的患者，射频导管消融成功后会出现房室逆传分离。对消融后有递减性逆传的患者应仔细进行电生理研究。
