射频消融治疗特发性室性心动过速的临床观察

Clinical study of radiofrequency catheter ablation in the treatment of idiopathic ventricular tachycardia.

目的 观察射频消融（RFCA）治疗9例特发性室性心动过速（IVT）方法和结果。方法 分别行激动顺序标测法和起搏标测法，对左室特发性室速（ILVT）7例，右室特发性室速2例，行射频消融治疗。结果 6例ILVT射频消融治疗成功，均起源于左室间隔面，有效消融靶点处P电位较体表心电图QRS起始点提前（34．6±8．9）ms（25～58ms），2例IRVT射频消融成功，有效消融靶点处与心动过速时的12导联心电图QRS波形完全相同。无一例出现并发症。结论 射频消融是治疗特发性宅性心动过速的有效方法.

Objective To evaluate the efficacy of radiofrequency catheter ablation （RFCA） in the treatment of idiopathic ventricular tachycardia （ IVT）, Methods Seven patients with idiopathic left ventrieular tachycardia （ILVT） and 2 patients with idiopathic right ventricular tachycardia（IRVT） were treated with RFCA to eliminate the ventricular tachycardia. Activation - mapping or pacing - mapping was used to localize the site of the ectopia marker of IVT. Results Six of 7 patients with ILVT and 2 patients with IRVT were successfully treated with RFCA, In successfully treated 6 patients with ILVT , the ablation sites were characterized by the Purkinje potential that was 25 - 58 ms（ 34.6 ±8.9 ms） earlier than the onset of QRS during tachycardia. Activation and pacing mapping studies disclosed the ILVT originated from the left ventricnlar septum. In successfully treated 2 patients with IRVT, pacing mapping produced the same QRS waves of 12 - lead ECG as spontaneous ventricular tachycardia There were no complieations during follow - up. Conclusion RFCA is an effetive therapy for the treatment of IVT, IVT can be ablated successfully immediately after the treatment is complete and for a long time.