起搏指导下射频消融治疗右侧希氏束旁室性期前收缩患者的远期观察

Long-term outcomes of catheter ablation for patients with right sided para-Hisian premature ventricu⁃lar contractions using a simple pacing strategy

目的探讨起搏指导下射频消融治疗右侧希氏束旁室性期前收缩的远期疗效和安全性。方法选择于2016年4月至2017年12月间在广东省人民医院接受射频消融术治疗,且术中采用起搏方法评估消融风险并指导消融的右侧希氏束旁室性期前收缩(para-Hisian premature ventricular contractions,PH-PVCs)患者15例,回顾分析其病历资料,收集患者临床基线、电生理资料及长期随访结果。结果手术立即成功率为86.7%,1例患者手术过程中出现完全性右束支阻滞(RBBB),术后随访过程中未能恢复。随访时间为(36±3)个月,手术成功率为80.0%,随访过程中未出现新发的不同程度的房室传导阻滞。结论起搏指导下射频消融治疗PH-PVCs患者有较高的远期成功率,是有效且安全的治疗方法。

Objectives To assess the long-term outcomes in right sided para-Hisian premature ventricular contrac⁃tions(PH-PVCs)patients who underwent radiofrequency(RF)ablation guided by pacing technique.Methods Totally 15 patients with right sided PH-PVCs had RF ablation procedures at Guangdong General hospital between April 2016 and December 2017 were included in this study.The medical records of these patients were retrospectively analyzed,and the clinical baseline,electrophysiological data and long-term follow-up results were collected.Results Premature ventricular contractions(PVCs)were successfully eliminated in 13/15(86.7%)patients.One patient had permanent right bundle branch block(RBBB).There was no recurrence in 12/15(80.0%)patients during(36±3)months follow up.Conclusions Using the pacing technique to guide RF ablation of PH-VAs was a safe and effective method.