射频消融治疗特发性室性心动过速103例

Radiofrequency Catheter Ablation for Idiopathic Ventricular Tachycardia in 103 Patients.

总结不同起源部位特发性室性心动过速(IVT)经导管射频消融(RFCA)治疗的成功经验。103例IVT行RFCA治疗,左室特发性VT(ILVT)起自间隔部者以最早的P电位处为靶点,右室特发性VT(IRVT)和其他部位的IVT均以起搏与VT发作时12导联心电图QRS波形态完全相同处或最早心室激动处为靶点。结果:RFCA治疗IVT的成功率为96.12%,ILVT为92.9%,IRVT为98.4%,复发率为2.9%。IVT起源部位分别位于左室后间隔部32例,左室游离壁1例,左室流出道9例,右室流出道60例、流入道1例。结论:IVTRFCA的关键是消融靶点的标测和确定,可根据VT发作时的心电图表现估计其起源位置。IVT的RFCA成功率高。

The purpose of this study was to report the effect of radiofrequency catheter ablation（ RFCA ） for idiopathic ventricular tacycardia （IVT）. Electrophysiological study and an radiofrequency catheter ablation were performed on 103 consecutive patients, and the target of left IVT was the site of earliest P potential on activation mapping in septal portion. Pacing and activation sequence mapping were used for right IVT and other IVT ablation. The ablation target was where 12- lead pacing ECG was entirely consistent with IVT attacks. The successful target was that IVT could not be induced by repeated programmed stimulation while intravenous isoprenaline was administered. Results： The successful ablation rate was 92.9% （39/42） in left IVT, while 98.4% （60/61） in right IVT. 3 patients （2.9%） recurrenced duing 29 ＋ 15 months follow-up period and were successfully reablated. Conclusion： RFCA has high success rate and few complications in treatment for IVT. Mapping the site and locating the origination of IVT are keys of RFCA. [ Chinese Journal of Cardiac Pacing and Electrophysiology, 2005,19 （ 5 ） ： 341 - 343 ]