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目的探讨不同X线投照体位下消融改良慢径治疗房室结折返性心动过速(AVN-RT)的疗效。方法AVNRT患者126例,按X线投照体位分后前位组40例、右前斜(30度)位组44例和左前斜(45度)位组42例;均经导管标测消融改良慢径。结果三组均100%成功消融改良慢径。希氏束(His)至冠状窦(CS)口距离、首获有效靶点时间、消融点数、累积放电时间和总X线时间三组间差异均无统计学意义(P>0.05)。三组术中发生一过性房室传导阻滞(AVB)各1例。随访3~6个月无一例复发。结论经导管消融改良慢径,三种X线投照体位标测均可行、有效。
Objective To investigate the effect of radiofrequency ablation and slow pathway reduction on atrioventricular nodal reentrant tachycardia (AVN-RT) under different X-ray irradiation positions. Methods A total of 126 patients with AVNRT were enrolled in this study. Forty-two AVNRT patients were divided into the anterior position group (n = 40), the right anterior oblique (30 °) position group and the left anterior oblique (45 °) position group according to the X- path. Results All the three groups were successfully ablated and improved the slow pathway. There was no significant difference in the distance between the His bundle and the coronary sinus (CS), the first valid target time, the number of ablation points, the cumulative discharge time and the total X-ray time (P> 0.05). One case had transient AV block in each group. Follow-up 3 to 6 months without a recurrence. Conclusions Transcatheter ablation improves the slow pathway, and the three X-ray mapping positions are feasible and effective.