冠状动脉窦内射频消融室性心律失常的研究

Radiofrequency catheter ablation of frequently ventricular tachycardia and ventricular premature contractions originating from the aortic cusp

目的分析在冠状动脉窦（简称冠状窦）窦内射频消融治疗频发性室性期前收缩和短暂阵发性室性心动过速的心电图特点和射频消融结果。方法对11例室性期前收缩、室性心动过速的患者进行心内电生理标测和射频消融治疗。结果室性期前收缩或室性心动过速均呈左束支阻滞图形,胸导联R/S均在V3导联之前,Ⅱ、Ⅲ导联均为高大R波,无切迹,电轴明显右偏。标测确定成功消融靶点在左冠状动脉窦内2例、无冠状动脉窦内5例、右冠状动脉窦4例,术中无并发症。随访2~25个月,均再无室性期前收缩。结论在冠状动脉窦内射频消融室性心律失常是可行的、安全的。

Objective To investigate the electrocardiographic characteristics and assess the results of radio frequency catheter ablation of ventricular tachycardia or ventricular premature contractions originating from the left aortic sinus cusp. Methods In addition to electrophysiological mapping, radiofrequeney catheter ablation was performed in 11 patients with ventricular tachycardia or ventricular premature contractions. Results The surface electrocardiogram QRS characteristics of ventricular taehycardia or ventricular premature contractions included left bundle branch block pattern, R/S〉I in lead V3（in 11 patients ）, R/S〉I in lead V2（in 7 patients ）, high ＂R＂ pattern in lead Ⅱ / Ⅲ. The ablation target was located in left coronary cusp in 2 patients, in no coronary cusp in 5 patients, and in fight coronary cusp in 4 patients. There were no complications in all patients. During a follow up of 2-25 months, there were no recurrence. Conclusions Frequently ventfieular taehycardia and short-term paroxysmal ventricular premature contractions originating from the aortic cusp can be cured successfully and safely used by radiofreqnency catheter ablation.