冠状动脉窦内射频消融治疗频发室性期前收缩和短暂阵发性室性心动过速

Radiofrequency catheter ablation of frequent premature ventricular contraction and ventricular tachycardia at the coronary cusp

目的分析在左冠状动脉窦及无冠状动脉窦内射频消融治疗频发性室性期前收缩和短暂阵发性室性心动过速的心电图特点和射频消融结果。方法对12例室性期前收缩、室性心动过速的病人进行心内电生理标测和射频消融治疗。结果室性期前收缩或室性心动过速均呈左束支传导阻滞图形,胸导联 V3R／S超过1有11例,V2R／S超过1有1例。I导联均为qs波有9例,Ⅱ、Ⅲ、aVF导联均为高大R波, 无切迹,标测确定成功消融靶点在左冠状动脉窦内9例、在无冠状动脉窦内3例,术中无并发症;随访1— 34个月,2例有偶发室性期前收缩。结论在左冠状动脉窦及无冠状动脉窦内射频消融是可行的、安全的。

Objectives To evaluate the eletrocardiographie characteristics and results of radiofrequency catheter ablation of frequent premature ventricular contraction （PVC） and ventrlcular tachycardia （VT） which can be cured by radiofrequeney ablation at the left coronary cusp and the noncoronary cusp, Methods In addition to electrophysiologieal mapping, radiofrequeney catheter ablation was performed in 12 patients with frequent PVC and VT. Results the surface electrocardiogram QRS characteristics of frequent PVC and VT included left bundle branch block pattern, R/S〉1 in lead V3 （in 11 patients）, R/S〉I in V2 （in 1 patient）：＂qs＂pattem in lead Ⅰ （in 9 patients）, and high ＂R＂ pattern in lead Ⅱ, Ⅲ ,aVF, Ablation target site were located in left coronary cusp in 9 patients, and in noncoronary cusp in 3 patient, There were no complication in all patients. During a follow up of （1-34）months, single PVC occurred in 2 patients, Conclusions Frequent PVC and VT can be successfully and safely cured by radiofrequency ablation at the left coronary cusp and the noncoronary cusp.