Analysis Of Recurrence Facts Of Paroxysmal Supraventricular Tachycardia After Radiofrequency Catheter Ablation

AIM To investigate the cause of paroxysmal supraventricular tachycardia (PSVT) recurrence after slow pathway and accessory pathway radiofrequency catheter ablation.METHODS Three hundreds and fifty-six cases with AVNRT and five hundreds and thirty cases with AVRT after RFCA were followed up for8.8±3.5year and 7.6±3.2 year respectively. Their electrophysiologic data were analyzed retrospectively.RESULTS Ten of 356 cases recurred and the recurrent rate was 2.8%. No recurrence was observed in the 320 cases without an atrial echo and " jump" phenomenon after RFCA. Three cases recurred in the 17 cases with an atrial echo but no" jump" phenomenon and no PSVT after RFCA. Five cases recurred in the 11 cases with an atrial echo and " jump" phenomenon but no PSVT after RFCA. Two cases recurred in the 8 cases with " jump" phenomenon but no an atrial echo and no PSVT after RFCA. Among the 10 recurrent cases, atrioventricular nodal effective refractory period(ERPAVN) after the second RFCA obviously lengthened compared with that after the first RFCA and the difference between ERPAVN and fast pathway ERP obviously diminished. No recurrence was observed in the 10 recurrent cases who had been treated with a second RFCA (2.6±0.6 year). Twenty-two of 530 cases recurred and the recurrent rate was 4.1%. Location of seventy-four cases accessory pathway were in right-sided free wall, four cases of them recurred, the recurrent rate was 5.4%; Location of eighty-two cases accessory pathway were in septal wall, five cases of them recurred, the recurrent rate was 6.0%; Location of three hundreds and seventy-four cases accessory pathway were in left-sided free wall, thirteen cases of them recurred, the recurrent rate was 3.4%. Among the twenty-two recurrence cases, seven cases had several accessory pathways,two kinds of mechanism. Between the recurrence group and no recurrence group, duration of VA melt wave was obviously different;ahead time of VA melt wave was also.CONCLUSION Slow pathway'remnant is the main cause of AVNRT recurrence after the slow pathway RFCA. Unaccuration of mapping target,several pathways are the main cause of AVRT recurrence after accessory pathway RFCA. Different electrophysiologic mechanism is the cause of PSVT recurrence after RFCA.