室性心动过速的心脏介入治疗

Cardiac intervention for treatment of patients with ventricular tachycardia

目的：评价室性心动过速(VT)合并不同血液动力学状态心脏介入治疗的安全性、有效性和介入方式选择。方法：血液动力学稳定的VT 2例，行射频消融治疗；血液动力学不稳定的VT 1例安装心律转复除颤器(ICD)。结果：2例血液动力学稳定的VT在中后间隔消融成功、消融能量20～30 W，放电90 s,术后随访3个月～2年，均无VT发作。心律转复除颤器(ICD)植入患者两年内有数次VT发作，均采用低能量(2 J)转复成功，无晕厥发生。结论：射频消融和ICD都是治疗VT安全而有效的方法，应根据血液动力学状态来选择正确的心脏介入治疗方式。

Objective:To evaluate the efficacy,safety and methods of choice in cardiac intervention for treatment of ventricular tachyc ardia(VT) with different hemodynamic patterns.Methods:Three patients with VT were taken for evaluation,2 with VT i n stable hemodynamic state were treated with radiofrequency ablation(RFA) and 1 with VT in unstable hemodynamic state was treated with implantable cardioversion defi brillator(ICD).Results:Ablation of VT with stable hemodynamic were performed succes sfully in middle and postseptal,with radiofrequency energy 20～30 W and ablation time 90 second.In 3～24 months follow－up study,no recurrence of VT in patient s after ablation.In patients with unstable hemodynamic,after implantation of ICD ,VT attacks were seen for several times,which is successfully converted to sinus rhythm with low energy(2 J),no syncope occurred.Conclusions:RFA and implantation of ICD are effective and safe for t reatment of VT.Method need for treatment should be selected according to the hem odynamic state of VT.