背景:His束的位置和距消融部位的距离对消融疗效和并发症风险的影响尚待探讨。我们确定了年龄之间的相关性,高度,体重指数(BMI),和他的包裹位置,以及His束与消融靶标(DHIS-ABL)之间的距离是否影响消融安全性和疗效。
方法:总的来说,回顾性分析346例房室结折返性心动过速(AVNRT)和96例房室折返性心动过速(AVRT)。His束与冠状窦口之间的距离(DHis-CS),他的束的高度(HHIS),和DHIS-ABL进行测量。消融后3个月获得心电图以评估复发和并发症。
结果:多元线性回归显示,两组HHIS均与年龄呈负相关。在AVNRT患者中,DHIS-ABL与年龄有关,高度,和BMI;DHIS-CS仅与年龄呈负相关。在AVRT患者中,DHIS-ABL与年龄之间没有显着相关性,高度,或BMI。AVNRT和AVRT组的复发率分别为0.9%和8.7%,分别。亚组分析显示,DHIS-ABL≤10mm的患者复发率高于DHIS-ABL>10mm的患者(p=0.013)。三度房室传导阻滞(AVB)并发症的发生率为0.2%。
结论:HHIS与年龄呈负相关,而与身高和BMI无关。DHIS-ABL与年龄相关,高度,AVNRT患者的BMI。短暂的DHIS-ABL导致室上性心动过速复发率较高;这是否会影响AVB风险,需要更大样本量的进一步研究。
BACKGROUND: The impact of the His bundle location and distance from the ablation site on ablation efficacy and complication risk remains unexplored. We determined the correlation between age, height, body mass index (BMI), and the His bundle location, and whether the distance between the His bundle and ablation target (DHIS-ABL) affects ablation safety and efficacy.
METHODS: Overall, 346 patients with atrioventricular nodal re-entrant tachycardia (AVNRT) and 96 with atrioventricular re-entrant tachycardia (AVRT) were retrospectively analyzed. The distance between the His bundle and the coronary sinus ostium (DHis-CS), the height of the His bundle (HHIS), and DHIS-ABL were measured. Electrocardiograms were obtained 3 months post-ablation to assess recurrence and complications.
RESULTS: Multiple linear regression showed that HHIS was negatively correlated with age in both groups. In AVNRT patients, DHIS-ABL was associated with age, height, and BMI; DHIS-CS was only negatively correlated with age. In AVRT patients, there was no significant correlation between the DHIS-ABL and age, height, or BMI. The recurrence rates in the AVNRT and AVRT groups were 0.9% and 8.7%, respectively. Subgroup analysis showed that patients with DHIS-ABL ≤ 10 mm had a higher recurrence rate than those with DHIS-ABL > 10 mm (p = .013). The incidence of third-degree atrioventricular block (AVB) complications was 0.2%.
CONCLUSIONS: HHIS was negatively correlated with age but not with height and BMI. The DHIS-ABL correlated with age, height, and BMI in AVNRT patients. A short DHIS-ABL led to a higher rate of supraventricular tachycardia recurrence; whether this affects AVB risk warrants further studies with larger sample sizes.