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目的依据房室结折返性心动过速（ＡＶＮＲＴ）患者冠状窦口向上扩张的研究结果，进一步探讨于冠状窦口 周围射频消融治疗ＡＶＮＲＴ的临床效果和安全性。方法对１５例ＡＶＮＲＴ患者在进行系统心内电生理检查后，进行 射频消融。此１５例病人靶点均选在冠状窦口附近，其中窦口上缘１２例，偏侧缘２例，近下缘１例。电位示小Ａ大 Ｖ，功率 １５～ ３０Ｗ，平均放电时间为（７２．０± １６．８）ｓ。结果 １２例一次放电成功，２例放电两次成功， １例三次就位放 电成功。其中９例出现交界性早搏，３例出现短暂交界性心律，３例无任何心律异常改变，无１例出现一过性或永久 性房室传导阻滞。随访３个月～１．５年均无心动过速复发。结论选择冠状窦口上缘行射频消融房室结慢径对 ＡＶＮＲＴ患者具有较佳的临床效果和较大的安全性。
Objective To investigate the clinical effect and safety of radiofrequency ablation around the coronary ostia around AVNRT based on the results of upward coronary ostium expansion in patients with atrioventricular nodal reentrant tachycardia (AVNRT). Methods Fifteen patients with AVNRT underwent systematic cardio-electrophysiological examination and radiofrequency ablation. The 15 patients were selected in the vicinity of the coronary ostium, of which 12 cases of the upper edge of the ostium, lateral margin in 2 cases, near the lower edge in 1 case. Potentials show small A large V, power 15 ~ 30W, the average discharge time (72.0 ± 16.8) s. Results 12 cases of a successful discharge, two cases of successful discharge, one case of three successful discharge in place. There were 9 cases of borderline premature beats, 3 cases of transient borderline arrhythmias, 3 cases of no change of heart rhythm, and no case of transient or permanent atrioventricular block. Follow-up 3 months to 1.5 years no recurrent tachycardia. Conclusions Radiofrequency ablation of the AV node with the superior margin of the coronary ostial ostium may have a better clinical effect and greater safety in patients with AVNRT.