导管射频消融治疗室性期前收缩的随访

Curative radiofrequency catheter ablation for ventricular premature beats

目的:研究射频消融治疗室性期前收缩的效果。方法:对60例频发、症状明显、药物治疗无效的室性期前收缩患者,根据体表心电图特点初步判断室性期前收缩来源,将大头消融电极置入左心室或右心室,用激动顺序标测及起搏标测法确定消融靶点,以12～40W,3～7min消融。以室性期前收缩在放电后10s内消失,维持稳定窦性心律30min为即刻成功标准。结果:消融即刻成功率95%(57/60)。术后随访(21±15)个月,无消融相关并发症发生。结论:经导管射频消融治疗室性期前收缩安全、有效,可作为症状严重,药物治疗无效或不能耐受患者的治疗选择。

Objective:To study the therapeutic effect of radiofrequency catheter ablation in ventricular premature beats. Method:Sixty patients with frequent and refractory symptomatic ventricular beats were envolled in this study, the site of origin in left ventricular or right ventricular was determined by electrocardial vector theory and ECG, then the target point was identified by both pace and activation mapping method, radiofrequency catheter ablation was performed in these patients. Result:Radiofrequency catheter ablation sucessed in 95% patients, no complications were encountered. During a mean period of 21±15 months follow-up, the patients with successful ablation were not given any antiarrhythmic drugs. Recurrence occurred in 3 patients of the 57 successful cases, and there were no late complications. Conciusion: Radiofrequency catheter ablation is an effective and safe treatment for symptomatic ventricular premature beats, it also improves the quality of life. Catheter ablation is a viable alternative to drugs in the presence of disabling symptoms.