心室流出道间的多通道传导现象

Phenomenon of multi-channel conduction in the ventricular outflow

目的探讨心室流出道（VOT）间多通道传导现象的心电图及电生理特征。方法2010年10月至2015年6月在温州医科大学附属第二医院心内科接受对859例射频消融术的室性早搏（PVC）／特发性室性心动过速（IVT）病例进行回顾性分析，发现有5例存在VOT间多通道传导现象，5例VOT起源的PVC（其中男1例），年龄31～56（40．6±10．9）岁，病程（24．6±10．1）个月，所有患者完成标测与消融，分析5例VOT间多通道传导患者的心电图及电生理特征。结果表现为左心室流出道（LVOT）起源PVC经LVOT及右心室流出道（RVOT）多通道传导2例，均经LVOT单点消融成功；表现为RVOT起源经RVOT及LVOT多通道传导3例，均经RVOT消融成功。结论VOT间多通道传导现象少见．了解并认识VOT间多通道传导现象，对进一步提高消融成功率将有所裨益。

Objective To investigate the electrocardiographic characteristics of the multi-channel conduction phenomennon in the ventricular outflow tract （VOT）. Methods From October 2010 to June 2015, a total of 897 patients received catheter ablation for PVC/IVT in the cardiology department of the Second Affiliated Hospital of Wenzhou Medical University, among them, 5 patients with PVC/IVT had multi-pathway conduction between ventricular outflow tracts. Electrocardiographic morphology indicated that arrhythmias might originate from VOT in 5 patients（ 1 males, average age of 40.6± 10.9 years old）undergoing radiofrequency catheter ab- lation（RFCA） , intraeardiae electrocardiographic characteristics and variations were analysed during the procedure of mapping and ablation. Results The premature ventricular contractions （PVC） were originating from left ventricular outflow tract（LVOT） , conducted by multi-channel between LVOT and right ventricular outflow（RVOT） ,and were successfully ablated in LVOT in two patients.The PVC were originating from RVOT, conducted via multi-channel between RVOT and LVOT, and finally were ablated in RVOT in three patients. Conclusions The phenomenon of multi-channel conduction in the VOT was rare.However, if this phenomenon is sufficiently recognized, a higher success rate of ablation can be expected.