特发性室性心动过速的射频消融治疗

Radiofrequency current catheter ablation of idiopathic ventricular tachycardia

射频消融术治疗特发性室性心动过速１５例。根据室速发作时体表心电图及心电轴初步定位起源点，采用激动顺序标测法与起搏标测法相结合，１５例均于局部标到较体表心电图ＱＲＳ波提前２０～４５ｍｓ的高频低振幅电位。起源点位于左室间隔区７例，右室流出道８例。放电功率２０～３０Ｗ，放电１０ｓ内室速全部终止，平均手术时间１．４ｈ，平均Ｘ线曝光２６分。无并发症，随访０．５～３．６年１例复发再次消融成功。

Radiofrequency catheter ablation was successful in 15 patients with idiopathic ventricular tachycardia The surface electrocardiogram combined with endocardial activation mapping and pace mapping located the ventricular ectopic focus The successful ablation sites were characterized by an endocardial activation time of 20￣45ms earlier than the onset of QRS during tachycardia and the earliest activation was preceded by an abnormal high frequency potential with low amplitude Sites of ventricular tachycardia origin included the left ventricular septum in 7 patients and right ventricular outflow tract in 8 patients During the Current deliverance,tachycardia of VT was terminated in 10 sec There were no complications All patients were followed for 0 5￣3 6 years,one patient had recurrent ventricular tachycardia and was successful ablated again