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左室特发性室性心动过速的射频消蚀治疗 被引量:37

Radiofrequency catheter ablation of idiopathic left ventricular tachycardia
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摘要 经导管射频消蚀治疗特发性左室室性心动过速(ILVT)缺乏大样本评价。该文介绍26例ILVT病人行射频消蚀治疗的经验。26例均为男性,年龄36±11岁。21例在室速发作中行激动标测与消蚀,即在左侧室间隔寻找心室波前有较体表心电图QRS波提前20ms以上的高频、低幅电位或最早心室激动处为消蚀靶点;5例因导管机械刺激终止室速或室速诱发后不能持续而采用起搏标测。26例病人全部一次消蚀成功,平均随访4个月,1例2个月后复发再治成功,无并发症。平均消蚀术时间1.6±1.1小时,X线照射时间26±16分钟,放电次数为4.0±1.8次,放电功率10~30W。成功消蚀靶点全部在间隔后半部分,主要位于间隔中部。结果表明射频消蚀治疗ILVT安全、有效,可作为这类病人的首选治疗。 Abstract Twenty six consecutive patients with idiopathic left ventricular tachycardia and without structural heart disease underwent radiofrequency catheter ablation therapy. All of the patients were males with a mean age of 36 ±11 years. The QRS configuration during tachycardia was of right bundle branch block with left axis deviation in all patients. Activation mapping and ablation during tachycardia were taken in 21 of them. The successful ablation sites were characterized by an endocardial activation time of 20 milliseconds earlier than the onset of QRS during tachycardia and the earliest activation was preceded by an abnormal high frequency potential with low amplitude. Pace-mapping and ablation were taken in 5 patients by a pace-mapping QRS similar to or closely resembling that during tachycardia. Radiofrequency ablation was successful in all 26 patients (100%) in the first procedure. There were no complications. A mean follow-up of 4 months showed one recurrence with successful reablation.Conclusions: Radiofrequency catheter ablation therapy is effective and safe in patients with idiopathic left ventricular tachycardia. It should be considered as the primary therapeutic modality in these patients.
出处 《中华心血管病杂志》 CAS CSCD 北大核心 1995年第1期21-24,共4页 Chinese Journal of Cardiology
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参考文献2

  • 1Wen M S,Circulation,1994年,89卷,1690页
  • 2胡大一,心律失常射频消蚀图谱,1994年

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