左心室来源特发性室性早搏临床特征及导管消融评价

Idiopathic premature ventricular contractions originating from the left ventricular outflow： clinical characteristics and evaluation of catheter ablation

目的 评价左心室特发性室性早搏（室早）的临床、体表心电图特点以及导管消融术的安全性和有效性.方法 入选2010年6月至2015年5月在新疆医科大学第一附属医院心脏中心经心电图和心内电生理检查明确诊断为左心室特发性室早的患者55例（男32例,女23例）,年龄12～77（50.36±17.24）岁,比较其体表心电图特点及行导管消融术的临床疗效.结果 55例左心室特发性室早患者中,起源于左心室流出道18例,主动脉窦30例,心大静脉远端7例（包括心外膜起源1例）.所有患者均接受导管消融术,即刻成功51例,消融成功率94.5％.所有患者术后平均随访（19±7）个月.随访期间7例患者出现室早复发,复发率12.7％.1例患者出现围术期并发症.结论 导管消融术治疗左心室起源的特发性室早是一种安全、有效的方法.

Objective To evaluate left ventricular idiopathic premature ventricular contractions clinical characteristics,body surface electrocardiogram characteristics and the safety and efficacy of catheter ablation.Methods Fifty-five cases,32 men,aged 12-77 （50.36± 17.24） diagnosed as idiopathic left ventricular premature contraction were recruited in this study from June 2010 to May 2015 in the First Affiliated Hospital of Xinjiang Medical University.The body surface electrocardiogram and intracardiac electrophysiology study （EPS） were performed and its characteristics were analyzed and the efficacy of catheter ablation was evaluated.Results Fifty-five cases with idiopathic premature ventricular contraction,originating from the left ventricular outflow tract in 18 cases,from aortic sinus in 30 cases,from distal great cardiac vein in 7 cases （including one case from epicardial）.All patients underwent catheter ablation,and 51 cases had immediate success,the ablation success rate was 94.5％.All patients were followed up for an average of （19 ± 7）months.During the follow-up period,and 7 patients had premature ventricular contraction early recurrence （12.7％）.One patient had perioperative complications.Condusion Catheter ablation of left ventricular idiopathic premature contractions is a safe and effective method.