射频消融治疗特发性心室颤动的研究

Radiofrequency ablation to premature ventricular beats for ventricular fibrillation prevention

目的:探讨射频消融治疗由室性期前收缩(PVB)触发的特发性心室颤动(VF)的效果。方法:常规心电图和动态心电图记录1例特发性VF患者的平常PVB。心内电生理检查诱导VF后,对触发VF的PVB和平常的PVB进行比较。运用起搏标测法寻找PVB的心室位点并行放电消融。术后每个月随访1次,并行动态心电图检查。结果:心内电生理检查可重复诱导出VF,VF均由触发PVB所诱导,触发PVB由2种形态构成,与平常的PVB不完全相同。起搏标测法确定PVB的位点后,放电消融成功。术后随访至今,患者无VF和晕厥发作。结论:特发性VF患者经射频消融治疗触发PVB可以有效地预防VF发作。

Objective：To investigate the role of radiofrequency ablation of premature ventricular beats （PVB） in preventing reappearance of ventricular fibrillation （VF） in one patient with idiopathic VF. Method：Usual PVB in the patient were recorded by electrocardiography and dynamic electrocardiography. Introcardiac electrophysiological examination was done in order to find VF induced by the trigger PVB. After comparing the trigger PVB with the usual PVB, pacing mapping was used to locate ablation target sites, and radiofrequency ablation was performed subsequently. Follow-up visit was performed once per month. Result： Introcardiac electrophysiological examination could induce VF triggered by PVB repeatedly. Trigger PVB with two types of configuration weren＇t the same as the usual PVB. After defining the target sites of above PVB, a successful ablation was accomplished. VF and syncope in this patient weren＇t present in follow-up visit up to now. Conclusion： Radiofrequency ablation of trigger PVB could prevent the reappearance of VF in patient with idiopathic VF.