Analysis On The Clinical Outcome Of 122 Cases Of Tachycardias Who Underwent Radiofrequency Catheter Ablation

【Objective】The purpose of this paper was to further reveal the mechanisms and improve the abilities of identifying atypical cases or special electrophysiological phenomena by analyzing the clinical outcomes of patients with tachycardia who had been undergone radiofrequency catheter ablation, thus providing guidelines for further clinical work. 【Methods】The clinical outcomes of 122 patients with tachycardia who had been undergone intracardiac electrophysiologic study(EPS) or radiofrequency catheter ablation (RFCA) were retrospectively analyzed. The patient population comprised 62 men and 60 women aged 13 to 76 (42.1±15.5)years old and the history of tachycardia was 2 days to 32(9.2±9.0) years. The clinical data of all cases of tachycardias who had been undergone intracardiac EPS or RFCA were analyzed, including the surface electrocardiograph(ECG), the transesophageal EPS , intracardiac EPS , target mapping, ablation and their follow-up. Especially, the unusual electrophysiological features of the most common tachycardias such as atrioventricular nodal reentrant tachycardia(AVNRT) and atrioventricular reentrant tachycardia(AVRT) during intracardiac EPS and RFCA were studied. 【Results】Among analyzed 122 cases, there were 53 cases of AVNRT( about 43.4%, including 5 patients with dual atrioventricular node pathways but uninducical tachycardia who had paroxysmal palpitation; strictly, these cases did not belong to AVNRT), 42 cases with antrogradely "jumping"conduction, 2 cases with retrogradely "jumping"conduction and 4 cases without "jumping"conduction but inducical tachycardia. There were 60 cases of AVRT(about 49.2%), with 61 accessory pathways(AP) including 49 left AP(47 cases of single AP and 1 case of double AP) and 12 right accessory pathways. Among all the cases of AVRT, there were 32 cases of concealed accessory pathways (CAP) and 28 cases of WPW(Wolff-Parkinson-White syndrome)(adout 53.3%,46.7%,respectively). In addition, there were 6 cases of ventricular tachycardiac(VT) with 3 cases of IVT, 2 cases of atrial tachycardiac(AT) and 2 cases of atrial flutter(AFL). esophageal EPS had been performed in 92 patients (about 75.4%), including 46 cases of AVNRT and 27 cases of CAP. The detective rate was 84.8% and 67.7% respectively. 112 cases had been undergone RFCA . The overall success rate in first session was 97.3%(109/112), in which AVNRT and AVRT had high success rate (about 99.1%). After a follow-up of 5 to 17 months, The recurrence was found in 3 patients(about 2.7%). No serious complication (such as complete atrioventricular block(AVB), pericardial tamponnade and pulmonary embolism) happened. 【Conclusion】radiofrequency catheter ablation can be performed effectively and safely in patients with tachycardia, especially in patients with AVRT and AVNRT. It could be clinically used as the first selection of therapy in some refractory tachycardia.