射频消融治疗二尖瓣环附近起源室性心律失常的临床分析

Clinical analysis of radiofrequency ablation ventricular arrhythmias originating near mitral annulus

目的:总结射频消融治疗二尖瓣环附近起源室性心律失常的安全性及疗效;分析其心电图特征及对标测消融的意义。方法:入选二尖瓣环附近起源室性心律失常射频消融患者48例,通过同步12导联体表心电图,分析其心电图特征及进行初步定位;在Ensite velocity 3.0Nav的导航下,利用激动标测和起搏标测相结合,确定消融靶点,使用温控标测消融导管进行消融。结果:本组手术成功率为95.8%,复发率4.2%,并发症发生率2.1%,二尖瓣环附近起源室性心律失常的体表心电图有一定的特征性。结论:射频消融治疗二尖瓣环附近起源室性心律失常是安全的、有效的;其体表发作图特征对其标测消融有指导作用。

Objective：To summarize safety and effect of treatment of ventricular arrhythmias originating nearby mitral annulus with radiofrequency ablation;and analyze the ECG characteristics and effect on mapping ablation.Method：We selected 48 patients attacked by ventricular arrhythmias originating nearby mitral annulus treated with radiofrequency ablation,and analyze the ECG characteristics and localize preliminarily through the synchronous 12 ECGs.Undering navigation of Ensite velocity 3.0Nav,we combined activation mapping with pace mapping to determine the ablation target,and used 7F-4extreme far-end ablation catheter（St.Jude）of 4mm for ablation.Result：In this group,the achievement ratio of operation was 95.8%,recurrence rate 4.2%,complication occurrence rate 2.1%,and surface ECG of ventricular arrhythmias originating nearby mitral annulus showed some characteristics.Conclusion：Treatment of ventricular arrhythmias originating nearby mitral annulus with radiofrequency ablation is safe and effective.The characteristics of the surface attack graph have guiding effect on mapping ablation.