射频导管消融治疗顽固性频发室性早搏伴短阵室性心动过速的体会

Radiofrequency Catheter Ablation Treated Symptomatic Frequencey Ventricular Premature Beat With Paroxysmal Unsustained Ventricular Tachycardia

报道 2 5例 (男 14例、女 11例 ,年龄 15～ 6 7岁 )顽固性频发室性早搏 (简称室早 )伴短阵室性心动过速 (简称室速 )接受RFCA的治疗结果。采用心室激动顺序与起搏标测法进行室早标测定位 ,标测到室早最早激动点较体表心电图QRS波提前 30ms以上或消融电极起搏心电图QRS波图形与室早图形完全一致时放电消融。结果 :2 5例患者室早起源分别为右室流出道 12例、右室心尖部 5例、左室游离壁 5例、左室近后间隔部 3例。 2 5例中 2 1例成功 (包括 1例频发室早伴短阵多形性室速患者 ) ,成功率为 84 % ,无并发症发生。结论 :RFCA治疗频发单形性室早伴短阵室速安全、有效。

We resport the treatment result of 25 patients (M/F 14/11, 15 to 67 years old) who were treated by radiofrequency catheter ablation (RFCA) with symptomatic frequencey ventricular premature beat (VPB) accompanied with paroxysmal non-sustained ventricular tachycardia(VT). The way of ventricular excited subsequently and pace-mapping were used to map and locate the site of VPB origin, when the site of origin,whose the earliest excitation point of VPB was earlier 30 seconds than QRS waves of surface ECG, or QRS waves of ablation electrode pacing electrogram was complete coincidence with VPB,was found radiofrequenay current was deliveried. Result: Among 25 patients,the VPB originated from right ventricular outflow tract in 12 patients, from right ventricular apex in 5 patients, from left free wall in 4 patients, from left posterior septum in 3 patients. The VPB successfully ablated in 21 of 25 patients without complication, including 1 patient with frequency monomorphic VPB accompanied with non-sustained polymorphic VT. The success rate was 84%. Conclusion: RFCA is an effective and safe for frequent monomorphic ventricular ectopic beats accompanied with non-sustained VT.