经导管心壁内化学消融治疗室性心动过速的实验研究

Ventricular Tachycardia Treated by Experimental Transcatheter Intramyocardial Chemical Ablation

采用经导管心壁内注射100％乙醇的化学消融方法治疗了15条犬的右心室心外膜下室性心动过速（室速），急性和慢性有效率均为100％。消融后30min和7天新室速的诱发率分别为20％（3／15）和16．7％（2／12）。室速对化学消融的反应有两种，一组（n＝11）于注射乙醇后2—3s内完全消失，另一组（n＝4）由间断发作到完全消失（3—5S）。注射乙醇后即刻心外膜下心肌发白、变硬并与周围心肌收缩不协调，病灶直径4±3mm；一周后病灶变为深红色，质地变软，与周围心肌收缩协调，范围无明显扩大（5±2mm）。

The subepicardiol focus of ventricular tachycardia (VT) of 15 dogs was treated by transcatheter chemical ablation of intramyocardial injection of 100% ethanol. The results showed that the effect rate of ablation was 100% but the induction of new VT in 7 days after ablation was 20% . The response of VT focus to the ablation included 1) completely ablated immediately within 2-3S (n11) and 2) effective from intermidiate to cornplete within 3-5S (n4). The subepicardial myocardium changed into white (diameter 4±3), stiffness and constracted asynchroniously with the surruondings after ablation immediately. And they changed further into deel) red (diameter 5±2mm) without stiffness and asynchronious constraction after 7 days. Therefore, the authers concluded that 1 ) the method of transcatheter intramyocardial chemical ablation is feasib1e on the treatment of VT and the effective rate could be 100%if the VT focus is located accurately, 2) the injury area after ablation is very small and could be repaired very soon, 3) wheather the induction of new VT after ablation suggests the longterm effect of proarrhythmic action of this method needs to be further evaluated.