방실결절 회귀성 빈맥환자의 도자절제시 성공한 위치의 심내 심전도 소견

Abstract

Ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia (AVNRT) can be performed by using a specific intracardiac electrogram findings predicting a successful radiofrequency catheter ablation. The purpose of the present study is to recognize a specific intracardiac electrogram findings predicting a successful sites of radiofrequency catheter ablation in patients with AVNRT. Materials and Methods：The study population consisted of the 18 patients (7 males, mean age：46 yr) to undergo successful catheter ablation using radiofrequency current in order to eliminate AVNRT from January 1993 to september 1994. We have analyzed local intracardiac electrogram at successful and unsuccessful sites of radiofrequency catheter ablation before the radiofrequency application: Atrial electrogram amplitude, duration, number of peaks in atrial electrogram, atrial/ventricular (A/V) electrogram amplitude ratio, and presence of His potential and/or slow potential. Results：Of 18 patients, 16 patients underwent a slow pathway ablation, the other 2 patients a fast pathway ablation. The mean A/V electrogram amplitude ratio at successful and unsuccessful sites was 0.69±0.91 and 1.86±2.03, respectively. The mean atrial electrogram duration and number of peaks at successful and unsuccessful sites was 57±16 msec vs 69±16 msec and 1.7±0.5 vs 2.2±0.7, respectively. His bundle electrogram was seen in one slow pathway ablated and one fast pathway ablated patient. No slow potential could be identified in any of these 18 patients. Conclusion：We think that A/V electrocardiogram amplitude ratio below 0.5 at posterior interatrial septum along tricuspid annulus is important marker indicating a successful ablation sites. (Korean Circulation J 1998;28(11):1852-1860) KEY WORDS：Slow pathway·Atrioventricular nodal reentrant tachycardia·Radiofrequency catheter ablation.