特发性右心室流出道室性心律失常起源部位的三维分布

Three dimensional distribution of the target sites of idiopathic ventricular arrhythmia originating from right ventricular outflow tract

目的:观察右心室流出道室性心律失常(RVOT-PVC/VT)消融靶点的三维分布规律。方法:60例右心室流出道室性心律失常消融术中,在EnSite-Array非接触标测系统指导下构建右心室流出道三维模型,以心内膜最早激动点设为靶点,以射频消融结果加以证实,观察靶点三维分布。结果:消融靶点在右心室流出道肺动脉瓣下的49例均消融成功,其中17例分布在游离壁,32例分布在间隔部;15例分布在上部,34例分布在下部;30例分布在前部,19例分布在后部。消融靶点分布于肺动脉瓣上11例,9例消融成功。结论:非接触标测系统有助于确定右心室流出道室性心律失常消融靶点的位置。

Objective：To explore the three dimensional distribution of the target sites of right ventricular outflow tract idiopathic ventricular arrhythmia （RVOT-PVC /VT）.Methods：Sixty consecutive patients were included in the study.The target sites were identified as the earliest activation point by non-contact mapping,and were confirmed by successful ablation.The distribution of the target sites was observed in three dimensional geometry of RVOT.Results：Catheter ablation was successful in 49 patients whose target sites were located below the pulmonary valve.Among them,the target sites were located in the superior area in 15 patients,the inferior area in 34 patients,the anterior area in 30 patients,the posterior area in 19 patients,the free wall in 17 patients and the septum in 32 patients respectively.Catheter ablation was successful in 9 of 11 patients whose target sites were located above the pulmonary valve.Conclusion：Non-contact mapping could be helpful for identification the catheter ablation target sites of RVOT-PVC/VT.