摘要
目的探讨单导管标测及射频消融治疗右心室流出道室性心律失常的临床疗效。方法96例症状严重的未发现器质性心脏病的右心室流出道室性心律失常患者，男性36例，女性60例，年龄14-73岁。96例中单纯频繁发作室性早搏（室早）53例，其他为室早和室性心动过速（室速）并存。动态心电图记录术前早搏（23834．6±13064．6）次／24h。所有病例均采用起搏标测，以起搏与自然发作室早、室速12导联心电图QRS波形至少有11个导联相同作为消融靶点。结果消融即刻成功率94．8％，X线曝光时间为（7．0±4．6）min，消融时间为（48．0±20．9）min。成功消融靶点位于间隔部73例，游离壁18例。消融后早搏（452．9±909．1）次／24h，与术前比较两者间差异有统计学意义（P〈0．001）。平均随访（20．7±11．9）个月，复发率为10．9％（10例）。其中行再次消融8例，成功5例。所有患者均未观察到急性及远期并发症的发生。结论单导管射频消融治疗右心室流出道室性心律失常安伞有效．并能减少操作及X线曝光时间。
Objective The object of this study was to assess the clinical effects of ablation of ven-tricular tachycardia （VT） or ventricular premature contractions （VPCs） in right ventricular outflow tract （RVOT） using a single catheter electrode. Methods Single catheter technique for RFCA was performed in 96 consecutive patients with severely symptomatic VPCs or VT in the RVOT. There were 36 men and 60 women, age range from 14 to 73 years. Fifty-three patients had pure frequent VPCs, others had coexistence of VPCs and VT. Mean frequency of VPCs was（23834.6±13064.6 ）/24 hours documented by 24-hour Holter monitoring. Target points were localized by pace mapping. Pace mapping demonstrated identical QRS complex configurations during pacing and during the arrhythmia in at least 11 leads. Results The immediate success rate was 94. 8%. The fluoroscopic time and procedure time were （7.0 ＋ 4.6 ）rain and （48.0 ± 20.9 ）min, respectively. Successfully ablation site were septal in 73 patients and free wall in 18 patients. The mean num- ber of VPCs.was （452.9 ± 909. 1 ）/24 hours with a P〈0.001 compared with before ablation. During follow-up period of （20. 7 ± 11.9） months, the recurrence rate was 10. 9% （ 10 patients）. Reablation was performed in 8 patients,and it was successfully done in 5 patients without recurrence. No acute or late complications encountered. Conclusions Single catheter technique for mapping and ablation of RVOT arrhythmias is effective and safe, meanwhile it can simplify the ablation procedure associated with reduced procedure duration and radiation exposure time.
出处
《中华心律失常学杂志》
2007年第5期372-377,共6页
Chinese Journal of Cardiac Arrhythmias
基金
湖北省重大科技攻关项目（2006A301A04）
武汉市优秀学科带头人计划资助（20065006071-2）
关键词
右心室流出道
室性心律失常
单导管
射频消融
Right ventricular outflow tract
Ventricular arrhythmia
Single catheter
Radiofrequency ablation
