经导管射频消融治疗室性心律失常的疗效观察

Clinical Effects of Radiofrequency Catheter Ablation on Ventricular Arrhythmia

目的探讨经导管射频消融治疗特发性室性心动过速及频发室性期前收缩的疗效及安全性。方法141例特发室性心动过速及频发室性期前收缩患者(男80例,女61例)采用激动顺序标测和(或)起搏标测方法行导管射频消融治疗。结果消融成功128例,成功率为90.8%,起源于右室流出道的室性心动过速或室性期前收缩消融成功率为92.0%。20例患者行消融前后的Holter检查,术前平均(21 824±12 769)次/24 h,术后平均(1 548±2 926)次/24 h,二者间差异有统计学意义(P<0.001)。随访3～36个月,10例复发并全部再次消融成功。无并发症发生。结论导管射频消融治疗症状严重且药物治疗无效的特发性室性心动过速或频发室性期前收缩是安全、有效、可行的方法。

Objective To evaluate the efficacy and safety of radiofrequency catheter ablation （RFCA） in patients with idiopathic ventricular tachycardia （IVT） and frequent ventricular premature （FVP）. Methods RFCA with activation sequence mapping and/or pace mapping was performed in 141 patients with IVT and FVP （80 males and 61 females）. Results RFCA was successful in 128 patients （90. 8% ）. The successful rate in IVT or FVP patients with the ectopic focus localized on the right ventricular outflow tract was 92%. The 24 - hour ambulatory electrocardiography was conduced in 20 patients before and after the operation, the difference in average beats/24h before the operation （21 824 ± 12 769） and after the operation （1 548 ±2 926） was statistically significant （ P 〈 0. 001 ）. During the period of 3 to 36 months follow - up, 10 patients relapsed and were all successfully re - ablated. No complication was found. Conclusion Radiofrequency catheter ablation （RFCA） is an effective safe and feasible treatment for patients IVT and FVP with severe symptoms and drug - resistant.