肺動脈瓣上射頻消融治療右室流出道形態室性早搏

Radiofrequency ablation above the pulmonary valves forpremature ventricular contractions with right ventricular outflow tract pattern

目的評估右室流出道形態(RVOT)形態室肺動脈瓣上射頻消融治療(RFCA)的可行性及安全性,分析相應的心電圖特徵,總結RFCA成功案例的經驗。方法分析和總結2018年6月~12月期間進行肺動脈瓣上RVOT形態室性早搏射頻消融3名患者的臨床資料、心電圖特徵、腔内心電圖及X光影像等資料。結果3名患者均成功在肺動脈瓣上進行RFCA,跟蹤隨訪期間未室性早搏復發,術中未發生嚴重併發症。肺動脈瓣上消融患者心電圖無特異性特徵,但腔内心電圖均記錄到反轉電位。結論RVOT形態室性早搏肺動脈瓣上消融安全、可行,但需要更多研究來進一步驗證。

Objective To assess the feasibility and safety of mapping and ablating above the pulmonary valves for premature ventricular contractions(PVC)with the right ventricular outflow tract(RVOT)pattern,and analyze the ECG features and summarize the experience of successful cases.Methods Three patients during June 2018 to December.2018 with RVOT pattern PVCS were ablated successfully using the above pulmonary valves approach were included.Basic clinical information,ECG features,intracardiac electrogram information and x-ray presentations were analyzed.Results PVCS of all three patients were successfully ablated above the pulmonary valves.During the follow up,no recurrence was found,and no severe side effects were observed.No special ECG features were found,but the incidence of reversible dual potentials was found high in intracardiac electrograms.Conclusion Ablation the RVOT pattern PVCs above the pulmonary valves seems feasible and safe,but need more cases and studies to strengthen the evidence.