顽固频发性室性早搏与特发性室性心动过速的射频消融治疗

Radiofrequency Catheter Ablation for Idiopathic Ventricular Tachycardia and Frequent Ventricular Premature Contractions

目的通过对48例顽固频发性早搏(室早)及特发性室性心动过速(室速)的射频消融的疗效观察,探索其射频消融治疗的有效性和安全性。方法48例顽固频发性室早与特发性室性心动过速患者,所有病例无器质性心脏病证据。男29例,女19例,年龄(45.3±6.8)岁,采用激动标测和起搏标测,确定室速和室早的起源部位,标测到靶点后行射频消融。并比较室早者消融前24小时动态心电图记录及消融后心电监护室早数。结果48例室早与室速多数起源于心室流出道占87.5%(42/48)。消融即刻成功率95.83%(46/48),其中33例顽固性室早24小时动态心电图记录消前室早数为(16016±2891)次,短阵室速(612±86)阵次,消融后室早数(142±170)次(P<0.001),无室速再发。所有病人无任何并发症。随访3～48个月未服用任何抗心律失常药物,复发率为4.4%(2/46)。结论经导管射频消融可有效而安全地消除正常心脏顽固频发性室早与特发性室性心动过速。

Objective To observe the results of radiofequency catheter ablation （RFCA）for idiopathic ventricular tachycardia（VT） and frequent premature ventricular contractions （PVCs）,and also to evaluate the feasibility and safety of PFCA for idiopathic ventricular tachycardia（VT） and frequent premature ventricular contractions（PVCs）.iethods This study included 48 patients（M/F,29/19）,mean age （45.3±6.8）years,All patients had no heart disease.The ablation was performed with routine endoeletrophysiological study,and pace-mapping combind with activation-mapping.To compare a mean frequency of PVCs after the ablation with the before.Results RFCA successed in 95.83%（46/48）.compare a mean frequency of PVCs （142±170）after the ablation with PVCs before the ablation （16016±2891）,P〈0.001,No complications encountered.During a follow up period of （2～18）months,Recurrence occurred in 2 patients in the 45 successful cases.Conclusion Radiofrequency catheter ablation is a safe and effective treatment for patients with idiopathic ventricular tachycardia and frequent premature ventricular contractions.Appropriate selection of patients is very important.