射频消融室性早搏治疗特发性心室颤动(附一例报道)

Radiofrequency Catheter Ablation of Premature Ventricular Beats to Treat Ventricular Fibrillation(A Report of One Case).

报道一例射频消融室性早搏 (简称室早 )治疗特发性心室颤动 (简称室颤 )。患者男性 ,2 3岁。 1个月内反复发作晕厥 4次 ,体表心电图和动态心电图证实频发室早。心室晚电位、倾斜试验、超声心动图检查均未发现异常。电生理检查时发作室颤 ,经 30 0J电击转复为窦性心律 ,回放 12导联心电图可见室颤前有频发室早。采用起搏标测 ,于右室游离壁起搏产生与室早 12导联心电图类同的QRS波 ,温控 5 0℃ ,5 0W ,消融 12 0s,室早消失。术后随访3个月 ,患者无晕厥发作。结论 :消融室颤触发物 (室早 )可预防室颤的发作。

We report that a patient with idiopathic ventricular fibrillation(VF) triggered by premature ventricular beats(PVBs) is successfully treated by catheter ablation.The patient,male ,was twenty three years old.He experienced syncope for 4 times within one month and the surface and dynamic electrocardiogram(ECG) showed frequent PVBs.Ventricular late potentials,tilt table testing,echocardiography didn′t show structural heart disease.VF occurred during electrophysiological test and was reversed into sinus rhythm by direct current(300 J).The ECG during VF occurred was analysed and that PVBs triggered VF was found.With pacing mapping ,the QRS complex at the right ventricular free wall was the same as the QRS complex during PVBs occurred in 12 lead ECG.The PVBs was successfully ablation(to achieve a temperature of 50℃,120 seconds).During 3 months of follow up ,the patients had no syncope.Conclusion:The successful catheter ablation of PVBs might prevent life threatening VF.