特发性室性心动过速持续发作下的急诊射频消融及远期随访

Emergency radiofrequency catheter ablation and long term follow-up of permanent idiopathic ventricular tachycardias

目的进一步评价特发性室性心动过速(IVT)持续发作下急诊射频消融(ERFCA)的可行性及其远期疗效。方法26例IVT患者(男16例,女10例,年龄48.6±10.2岁)均在持续发作下完成血管穿刺、置入导管、电生理检查及射频消融,并采取门诊或电话定期随访的形式,跟踪5年以上,进一步明确IVT行ERFCA的远期疗效及影响预后的因素。结果26例中有2例IVT复发,经再次射频消融成功,1例左后间隔IVT在ERFCA中并发Ⅲ度房室传导阻滞(AVB),同期置入VVI永久起搏器,随访期间起搏、感知功能良好,室性心动过速亦未复发。均无迟发性AVB或其它并发症发生。结论IVT持续发作下,行ERFCA治疗安全可行,且远期效果良好。

Objective To estimate the practicability and long term effectiveness in the emergency radiofrequency catheter ablation （ERFCA） of permanent idiopathic ventricular tachycardia （IVT）. Methods Twenty-six cases （ 12 males, mean age 48.6 ± 10.2 years） of IVT who were operated by vascular puncturina, catheter insertion, electrophysiological examination, radiofrequency ablation and were followed up in out patient department and by telephone. The long term effectiveness and the factors which affect the prognosis of the ERFCA of IVT were studied. Results In the 26 cases, two cases recurred and were successfully ablated the second time, and there was one case complicated by third degree atrioventricular block （AVB） in the ERFCA and VVI permanent pacemaker was planted, whose impulse and sensitivity were good during the follow-up, and no more recurrence of ventricular tachycardia, and all the others did not have delayed AVB or other complications. Conclusions The clinical feature of IVT is inclined to be endless. ERFCA is safe and practicable, and have a good long term effectiveness.