肺动脉窦起源室性早搏标测消融方法对比及有效性分析

Comparison and effectiveness analysis of mapping ablation methods for Premature Ventricular Contraction originating from the pulmonary sinus

目的对比肺动脉窦部起源室性早搏(PVC)的标测消融方法及有效性。方法回顾性分析2021年1月至2021年12月于郑州市第七人民医院心内科因右心室流出道PVC行导管射频消融的131例患者病例中,术中可明确来源于肺动脉窦的66例,将其根据术中消融导管标测及消融方法分为传统消融组(n=30)和倒U弯法消融组(n=36),对比两组患者消融靶点位置、术中消融时间、即刻成功率及并发症情况。结果倒U法导管消融组患者中18例肺动脉左窦起源,13例肺动脉右窦起源,5例肺动脉前窦起源;传统消融组患者中15例肺动脉左窦起源,8例肺动脉右窦起源,7例肺动脉前窦起源。倒U法导管消融组手术时间短于传统消融组(P<0.05),倒U法导管消融组术中无手术相关并发症发生。传统消融组术中出现1例心包填塞,1例术后PVC复发而再次消融。结论对于肺动脉窦起源的PVC,使用倒U法消融是安全有效的,且明显缩短手术时间。

Objective To compare the mapping and ablation methods for pulmonary sinus-derived ventricular premature beats(PVC)and their effectiveness.Methods A retrospective analysis was conducted on 131 patients who underwent catheter radiofrequency ablation for right ventricular outflow tract PVC(Premature Ventricular Contraction)in the Cardiology Department of the Seventh People's Hospital of Zhengzhou City from January 2021 to December 2021.Among them,66 cases were confirmed to originate from the pulmonary artery sinus during the surgery.These cases were divided into two groups based on intraoperative ablation catheter mapping and ablation technique:the traditional ablation group(n=30)and the inverted U-curve ablation group(n=36).The two groups were compared in terms of ablation target location,intraoperative ablation time,immediate success rate,and complication incidence.Result Inverted U curve ablation was performed in 36 patients with PVC(There are 18 cases origins from the left sinus,13 cases origins from right sinus,5 cases origins from anterior sinus of the inverted U-curve ablation group.There are 15 cases origin from the left sinus,8 cases origin from the right sinus,7 cases origin from anterior sinus of the traditional ablation group.The operation time of the inverted U ablation group was significantly shorter than that of the traditional ablation group(P<0.05).No surgery-related complications occurred during the operation.In the traditional ablation group,1 patient had pericardial tamponade during the operation,and 1 patient had recurrent PVC ablation after the operation.Conclusion For PVCS originating from pulmonary sinuses,inverted U ablation is safe and effective compared with traditional mapping ablation,and can significantly reduce the operation time.