关键词: 心动过速，房室结折返性;慢径;消融;复发

    摘 要:目的 了解房室结折返性心动过速(AVNRT)射频消融慢径术后与AVNRT复发有关的因素. 方法 366例典型AVNRT患者经射频消融慢径后，35例(10%)复发.观察射频术后仍有残余慢径传导;释放射频能量时无加速性结性心动过速;存在房室结“回波”及快径与慢径有效不应期变化四个因素与AVNRT复发的关系. 结果 35例复发者中均有残余慢径传导(100%)，331例未复发者中211例(64%)存在残余慢径前向传导(P<0.01).35例复发者中24例(69%)存在房室结“回波”，而在有残余慢径传导未复发的211例患者中有房室结“回波”仅11例(5.2%)(P<0.01);35例复发者中6例(17%)放电时无加速性结性心动过速出现，331例未发者中仅2例(0.96%，P<0.01);复发组房室结快径与慢径有效不应期之差为(47±25)ms，未复发组为(12±4)ms(P<0.05). 结论 射频消融房室结慢径后存在残余慢径传导，出现房室结回波，释放射频能量时无加速性结性心动过速及残余慢径有效不应期长与复发AVNRT有关.

    Predictors of recurrence of atrioventricular nodal reentry after selective slow pathway ablation

    ZHANG Qing，WANG Hai-Chang，ZHANG Dian-Xin，LIU Bing，LI Yuan，LI Wei，WANG Xiao-Yan

    Department of Cardiovasology，Xijing Hospital，Fourth Military Medical University，Xi'an710033，China

    Keywords:tachycardia，atrioventricular nodal reentry;slow pathway;ablation;recurrence

    Abstract:AIM To assess the predictors of recurrence of AV nodal reentrant tachycardia(AVNRT)after selective ra-diofrequency ablation of the slow pathway.METHODS A total of366consecutive patients with AVNRT had been successfully treated with selective slow pathway ablation by radiofrequency.The occurrence rates of accelerated junction-al tachycardia during radiofrequency application ......