经导管心壁内化学消融治疗室性心动过速的实验研究

The Experimental Study of Transcatheter Intramyocardial Chemical Ablation for Treating Ventricular Tachycardia

经导管心壁内注射１００％乙醇消融１５条犬右室心外膜下室性心动过速（ＶＴ），急、慢性有效率１００％。注射乙醇后ＶＴ于２～３ｓ内完全消失（１１条）；在３～５ｓ内由间断出现到完全消失（４条）。注射后即刻心外膜下心肌发白并与周围收缩不协调，病灶直径４±３ｍｍ；七天后变深红色，收缩协调，范围略扩大（５±２ｍｍ）。消融后３０分钟和七天新ＶＴ诱发率为２０．０％（３／１５）和１６．７％（２／１２）。作者认为：①经导管心壁内化学消融ＶＴ的方法可行，准确定位后成功率可达１００％。②心壁内注射１００％乙醇后病灶局限、修复快。③术后较高的新ＶＴ诱发率提示潜在的远期促心律失常作用。

The subepicardial focuses of ventricular tachycardia(VT)of 15 dogs were treated by transcatheter chemical ablation of intramyocardial injection of 100%ethanol.The results showed that the effective rate of ablation was 100%,but the induction rate of new VT after 7 days was 16.7%. VT disappeared completely in 11 cases within 2～3 s and intermidiatly in 4 cases within 3～5s.The subepicardial myocardium changed into white stiffness(diameter 4±3mm) and constracted asynchroniously with the surroundings after ablation immediately.After 7days,the myocardium changed further into deep red(diameter 5±2mm) and synchronious constraction.Therefore,the authors concltids that:(1)the method of transcatheter intramyocardial chemical ablation is feasible on the treatment of VT and the effective rate can be 100%if the VT focus is mapped accurately;(2)the injury area after ablation is very small and can be cured very soon;(3)The induction of new VT after ablation suggests the longterm effect of proarrhythmic action of this method needs to be further evaluated.