The Fast Pathway Retrograde And Prequels Functional Changes Study After The Slow Pathway Ablation

Objective:This study was designed on the basis of previous studies, By strictly controlling research conditions, Innovation of observing indicators, adding research perspective about retrograde functions after the slow pathway ablation in patients with AVNRT, discussion fast pathway conduction function changes after slow pathway ablation in patients with slow-fast atrioventricular nodal reentrant tachycardia (SF-AVNRT), and then by observing the conduction changes after slow pathway ablation to speculate atrioventricular node function relationship between fast pathway and slow pathway, provide a reliable basis in the electrophysiological aspects for the exact structure of the atrioventricular node in further study.Methods:For 112 cases patients who due to the onset of palpitations hospitalized in our department had intracardiac electrophysiology in november 2013 to August 2014, including 48 cases diagnosed by intracardiac electrophysiology as significant jump phenomenon SF-AVNRT. These 48 patients electrode repositioning to the standard position, then underwent high right atrium (HRA) stimulus with S1S1 500ms stimulus, measured His 1,2 AH spacing(Atrioventricular node conduction time). then S1S2 stimulus to measure the jumping point and jumping tine on atrioventricular node, AS the jumping point to the effective refractory period (ERPa), then RV S1S1 500ms stimulate to determined His 1,2 HA spacing as atrioventricular node retrograde time, S1S2 stimulus measure atrioventricular node retrograde jump point and the effective refractory period (ERPI), Then those patients were treated by slow pathway radiofrequency ablation, Conventional method uses lower ablation, slow nodal rhythm to appear as valid, As HRA S1S2 stimuluswithout AH jump and no atrioventricular nodal reentrant to the end of surgery. Repositioning the electrode to standard position after surgy, Measured the fast pathway prequel and retrograde conduction time (TFP) and effective refractory period(ERPFP) with the same conditions and methods as before.Finally, compare preoperative with postoperative whether there is a change on the conduction time and the effective refractory period, then presumably the relationship between the fast and the slow pathway of the atrioventricular node according to the findings.Results:1、Fast pathway prequel time (TFPP) from preoperative106.04± 36.36ms shorten to postoperative 89.98±27.09ms, P<0.001; 2、The fast pathway effective refractory period(ERPFPP)from preoperative330.00+53.31ms shorten to postoperative 250.21+56.81ms, P<0.001; 3、The fast pathway retrograde time(TFPR) from preoperative 94.54+28.39ms shortened to postoperative 86.62 +24.88ms, P=0.010; all the difference was statistically significant.Conclusion:The fast pathway prequel and retrograde functions are improved after slow pathway ablation.