心室反应在射频消融特发性室性心动过速中作用的临床研究

Ventricular responses in radiofrequency catheter ablation of idiopathic ventricular tachycardia:A clinical study

目的 探讨心室反应 (VR)在射频消融IVT的作用。方法 应用体表心电图、心内膜激动标测及VR相结合的方法射频消融 13例IVT病人。以激动标测初选靶点 ,射频消融试放电产生的VR确定靶点 ,采用VR与VT发作相一致处为靶点消融。结果 13例IVT即刻消融成功率 13/ 13。VR表现 :(1)窦性心律下消融时出现与VT发作相一致的VR。随后室性心动过速 (VT)中间断出现窦性心律、双发或联律室性早搏 ,最终完全恢复成窦性心律。 (2 )出现与VT发作不一致的VR。结论 以VR与VT发作相一致处作靶点 ,产生与VT发作相一致的VR可被视为有效消融的指标。

Objective To study the role of ventricular responses(VR) in radiofrequency catheter ablation (RFCA) of idiopathic ventricular tachycardia(VT).Methods Thirteen patients underwent RFCA by using a combination of surface ECG,activition mapping and VR.The ablation targets were primarily selected by activition mapping and was determined by the VR in RFCA,and then,the final ablation target was determined and ablated where VR and VT had the same ECG results.Results Thirteen patients were successfully ablated.The VRs showed:the VR induced by RFCA in sinus rhythm was just the same as VT;intermittent sinus rhythm appeared between VT;two couple or couplets,or premature beats appeared intermittently in sinus rhythm,and finally sinus rhythm appeared;the VR induced by RFCA was not the same as VT.Conclusion The ablation target should be the site where the VR induced by RFCA is just the same as VT;the occurence of VR that is just the same as VT can be the predictor of successful ablation.