特发性室性心动过速的射频消融治疗

RADIOFREQUENCY CATHETER ABLATION FOR IDIOPATHIC VENTRICULAR TACHYCARDIA

探讨特发性室性心动过速 (IVT)的心电图特征和特殊部位IVT消融方法。对 41例IVT的心电图特征和导管射频消融结果进行了分析。结果 :心电图呈右束支阻滞者 2 8例 ,呈左束支阻滞者 9例 ,平均心室率(172± 30 ) /min ;消融成功率 90 .2 % (37/ 41)。表明导管消融对IVT具有较高的成功率。对左室特发室速 (IL VT)采用激动标测 ,对右室流出道室速 (RVOT VT)采用起搏结合激动标测 ;对左室流出道室速 (LVOT VT)

Twenty nine male and twelve female patients with idiopathic ventricular tachycardia (IVT)were treated with radiofrequency catheter ablation(RFCA).The electrocardiagraphic features of IVT and the results of RFCA were studied. All patients suffered from tachycardia for 3 months to 2 years.Results:①The electrocardiographic features of VT were showed as RBBB in 32 cases, and LBBB in another 9 cases. Mean ventricular rate was (172 30)/min.②37 of 41 (90.2%) patients were treated with RFCA successfully. ③The distribution of target sites included left ventricular septum in 24 cases, left ventricular outflow tract in 3 cases,left ventricular free wall in 3 cases,left anterior branch in 1 case, right ventricular outflow tract in 5 cases,and right ventricular infow tract in 1 case.Conclusion:RFCA for IVT had a high successful rate.Activation sequence mapping was applied in ILVT,and paced activation sequence mapping applied in RVOT VT. Injury to the aortic valves and coronary artery should be avoided during ablation of LVOT VT.