老年特发性室性心动过速患者的射频消融

目的了解老年特发性室性心动过速患者的临床特征、手术效果以及并发症。方法回顾分析1998年3月至2011年12月在解放军总医院住院行导管射频消融术且年龄大于60岁的患者36例的心律失常起源部位、手术过程和结果。结果大于60岁的患者36例,最大年龄是82岁,其中男性22例,女性14例,8例患者出现过黑矇症状,3例患者出现过晕厥症状。心律失常起源于流出道的32例,右室流入道的3例,左心室前壁的1例,没有起源于左室左前分支的束支性的室性心动过速。起源于右室流出道的17例,左室15例。手术成功的患者27例,失败的患者8例,复发1例,1例术中出现急性心包压塞。结论在特发性室性心动过速的老年患者组中,心律失常的起源部位较低年龄组差异有统计学意义,而手术成功率和并发症发病率差异无统计学意义。

objective The aim of the study was to describe the clinical feature,the result of ablation and the origins of the idiopathic ventricular arrhythmias in the elderly patients.Methods We studied 36 elderly patients of 270 patients with idiopathic ventricular arrhythmias who were admitted to our department in the past 13 years.All of them underwent catheter mapping and radiofrequency catheter ablation.Results Of all the elderly patients,the oldest patient is 82 years old,22 males and 14 females.8 patients had a history of near-syncope,and 3 patients had history of syncope.There are 32 patients with a ventricular outflow tract origin,3 patients with a ventricular inflow tract origin,1 patient with a left anterior ventricular wall and no patient with idiopathic left ventricular tachycardia.Of 36 patients with a ventricular outflow tract origin,there are 17 patients from the right and 15 patients from the left.The ablation success rate in the elderly patients was 58%.In a 60 years old patient,Tamponade ocuured during ablation.Conclusion There were age differences in the the incidence of I-VA according to their site of origin.There were no differences of the rate of the ablation success and the main complication between the elderly and the young.