Jaïs P, Haïssaguerre M, Gencel L, Shah D C, Le Métayer P, Clémenty J
Hôpital Cardiologique du Haut-Lévêque.
Arch Mal Coeur Vaiss. 1996 Feb;89 Spec No 1:83-7.
Atrioventricular nodal reentrant tachycardias which, for a long time, could only be treated medically, may now benefit from catheter ablation. The rapid retrograde pathway was an effective initial target but carried a risk of complete atrioventricular block of about 10%. Nowadays, most operators deliver the radiofrequency energy (endocavitary cautery) to the slow nodal pathway. Different techniques of guidance (anatomical, electrophysiological, rapid potential, slow potential) are associated with high success rates: 90 to 100%. However, experimental studies suggest that the slow potentials arise from transitional cells within the tachycardia circuit (the anatomical substrate of the slow pathway). There is still a risk of complete atrioventricular block (1 to 5%) which should be clearly explained to patients referred for ablation of this constantly benign arrhythmia.
房室结折返性心动过速长期以来只能通过药物治疗，现在可能受益于导管消融术。快速逆向传导通路是有效的初始靶点，但存在约10%的完全性房室传导阻滞风险。如今，大多数操作者将射频能量（心腔内烧灼）作用于慢径路。不同的引导技术（解剖学、电生理学、快电位、慢电位）成功率很高：90%至100%。然而，实验研究表明，慢电位起源于心动过速环路内的过渡细胞（慢径路的解剖学基质）。仍存在完全性房室传导阻滞的风险（1%至5%），对于因这种始终为良性的心律失常前来接受消融治疗的患者，应明确告知这一风险。
