以右室流出道尖峰电位指导射频消融治疗室性心律失常

Value of spike potentials in guiding catheter ablation of ventricular tachyarrhythmias originated from the right ventricular outflow tract.

目的探讨以右室流出道尖峰电位指导消融右室流出道室性心律失常的可行性与效果。方法39例特发性室性心律失常患者,心电图初步定位心律失常起源于右室流出道。将患者分为尖峰电位标测组(n=20)和起搏标测组(n=19)。尖峰电位法的消融靶点为激动最提前的尖峰电位。结果尖峰电位组20例患者中有3例因未能标测到尖峰电位,故转为单纯起搏标测组,成功率为94.1%(16/17)。单纯起搏标测组中1例未能诱发心律失常,1例因并发症终止手术,1例消融失败,成功率为95.0%(19/20)。两组的成功率差别无显著性(P>0.05),但尖峰电位组操作时间(55±20.1 mins)和X线透照时间(27±12.5 mins)均低于起搏标测组(分别是72±27.8 mins;36±14.1mins。P均<0.05)。结论尖峰电位指导右室流出道室性心律失常消融是一种安全有效的标测方法。

Objective To investigate the value of spike potentials in guiding the catheter ablation of ventricular arrhythmias（VA） originated from the fight ventricular outflow tract （RVOT）. Methods Thirty-nine patients with VA were divided into spike potential guided ablation group （Group A, n = 20） and pace-mapping guided ablation group（ Group B, n = 19）. Results Three patients from group A were transferred to group B due to the spike potential was not found during ROVT mapping. Radiofrequency catheter ablation was successfully in 16 of 17 patients in group A and in 19 of 20 patients in Group B （ P 〉 0.05 ）. The procedure time and X-ray time in group A were shorter than those in group B （55 ± 20.1 mins vs 72 - 27.8 rains, P 〈 0.05 ; 27 ± 12.5 mins vs 36 ± 14.1 mins, P 〈 0.05 ）. Conclusion Spike potential guided mapping is safe and effective in ablating the catheter ablation of VA from the RVOT. [ Chinese Journal of Cardiac Pacing and E- lectrophysiology,2009,23 （5） ： 393 - 395 ]