Talwar K K, Singh B, Goel P, Bahl V K, Kaul U, Wasir H S
Department of Cardiology, All India Institute of Medical Sciences, New Delhi.
Indian Heart J. 1996 Nov-Dec;48(6):685-90.
Two hundred and one consecutive patients with symptomatic paroxysmal supraventricular tachycardia (PSVT) underwent a diagnostic electrophysiological test and catheter ablation with radiofrequency (RF) current. In 102 (51%) patients, the mechanism of PSVT was found to be atrioventricular nodal reentry (AVNRT, typical in 101, atypical in 1). Atrioventricular reentrant tachycardia (AVRT) involving accessory pathway was present in 94 (47%) and ectopic atrial tachycardia in 5 patients. A successful outcome was achieved in 100 of 102 patients (98%) with AVNRT and in 85 of 94 patients (90%) with AVRT. The anatomical approach was used for ablation in patients with AVNRT. The focus was ablated in 4 patients with ectopic atrial tachycardia whereas it was modified in the remaining one patient. Procedure-related complications occurred in 4 patients (2 AVNRT, 2 AVRT). One patient each developed haemothorax, pericardial effusion, mitral valve endocarditis and high-grade AV block requiring permanent pacemaker implantation. The electrode and ablation catheters were repeatedly used after ethylene oxide sterilisation to reduce the cost of the procedure. RF ablation is an effective, safe and curative modality of treatment for patients with symptomatic PSVT due to AVNRT and AVRT. The experience with this modality in patients with ectopic atrial tachycardia is limited.
201例有症状的阵发性室上性心动过速(PSVT)患者连续接受了诊断性电生理检查及射频(RF)电流导管消融术。在102例(51%)患者中,发现PSVT的机制为房室结折返性心动过速(AVNRT,典型者101例,非典型者1例)。涉及旁路的房室折返性心动过速(AVRT)有94例(47%),5例为异位房性心动过速。102例AVNRT患者中有100例(98%)、94例AVRT患者中有85例(90%)获得成功结果。对AVNRT患者采用解剖学方法进行消融。4例异位房性心动过速患者的病灶被消融,而其余1例患者的病灶被改良。4例患者(2例AVNRT,2例AVRT)发生了与手术相关的并发症。各有1例患者出现血胸、心包积液、二尖瓣心内膜炎及需要植入永久起搏器的高度房室传导阻滞。环氧乙烷灭菌后电极和消融导管被反复使用以降低手术成本。对于因AVNRT和AVRT导致的有症状PSVT患者,RF消融是一种有效、安全且可治愈的治疗方式。在异位房性心动过速患者中使用这种治疗方式的经验有限。