射频消融室性早搏逆转心动过速性心肌病七例

Reversion of tachycardiomyopathy by ablation of premature ventricular contractions in seven patients

目的总结室性早搏(简称室早)导致的心动过速性心肌病的临床特点及射频消融疗效。方法频发单源性室早导致的心动过速性心肌病7例,长程心电图示24 h总早搏个数为33 117±11 173个,均行射频消融治疗室早。分析其临床特点并观察术前术后超声及长程心电图各项指标的变化。结果射频消融室早后6个月,心功能(NYHA分级)明显改善(1.0±0.12级vs 2.2±1.1级,P<0.01);左室舒张末期内径变小(45±9 mm vs 59±15mm,P<0.01);左室射血分数增高(0.55±0.09 vs 0.40±0.08,P<0.01)。结论频发室早可引起心动过速心肌病,射频消融室早可逆转心肌病。

Objective To summarize the clinical characteristics of tachycardiomyopathy induced by premature ventricu- lar contractions （ PVCs ） and its curative effect by radiofrequeney catheter ablation. Methods Seven patients, with PVCs-induced tachycardiomyopathy, with 33 117 ± 11 173 PVCs in 24 h Holter ECG who underwent catheter ablation were enrolled in this study. The clinical characteristics and the changes of Holter ECG and echocardiography were compared before and after the ablation. Results Six months after the ablation, cardiac function of New York Heart Association （ NY- HA） class was improved significantly （ 1.0 ±0.12 grade vs 2.2 ± 1.1 grade,P 〈0.01 ） ; Left ventricular end-diastolic dimension （LVEDD） reduced significantly （45 ±9 mm vs 59 ± 15 mm,P 〈0.01 ）; Left ventricular ejection fraction increased significantly （0.55 ± 0.09 vs 0.40 ± 0.08,P 〈 0.01 ）. Conclusions Frequent PVCs may induce tachycardio-myopathy which can be reversed by catheter ablation.