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起源点邻近二尖瓣环的室性期前收缩/室性心动过速心电图特征及射频导管消融治疗 被引量:5
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作者 林加锋 林佳选 +4 位作者 季亢挺 李嘉 殷日鹏 李岳春 李进 《浙江医学》 CAS 2012年第17期1409-1415,1423,共8页
目的探讨起源点邻近二尖瓣环特发性室性期前收缩和(或)室性心动过速(PVCsNT)的体表心电图特点及射频导管消融(简称消融)治疗的疗效与安全性。方法10例起源点邻近二尖瓣环的特发性PVCs/VT,男7例,女3例,其中8例行动态心电图检... 目的探讨起源点邻近二尖瓣环特发性室性期前收缩和(或)室性心动过速(PVCsNT)的体表心电图特点及射频导管消融(简称消融)治疗的疗效与安全性。方法10例起源点邻近二尖瓣环的特发性PVCs/VT,男7例,女3例,其中8例行动态心电图检查,其PVCs/VT总数11387~39672(237144-9493)次/24h,所有患者接受消融治疗,分析其体表12导联心电图的QRS波群特征及其变化规律。结果消融成功8例(成功率80.0%),均无并发症发生。根据X线影像定位,7例起源于二尖瓣环心内膜(4例起源于前侧壁)采用普通温控导管消融成功6例,1例因起源点邻近希氏束放弃消融;3例起源于二尖瓣环心外膜前侧壁经心大静脉远端采用盐水灌注导管消融成功2例,1例采用普通温控导管因阻抗高,不能放电失败。起源于二尖瓣环心内膜PVCs/VT的心电图特征存在下列变化规律,即由二尖瓣环后侧壁→侧壁→前侧壁,下壁导联的r(R)波逐渐增高而s(S)波逐渐变浅甚至消失;间隔起源者在V,常呈qR或QR型,而游离壁起源者常呈R或rsR‘型;多数患者V5~V。有S波呈Rs型;二尖瓣环前侧壁心外膜消融成功者与相对应位置心内膜消融成功者除有更长的假性“6”波时间(前者≥67ms而后者〈67ms)外,其他特征并无区别。结论起源点邻近二尖瓣环的PVCsNT,是特发性PVCs/VT的一个亚组,前侧壁是好发区域,消融治疗安全有效,部分患者需经冠状静脉窦至心大静脉远端、采用盐水灌注导管进行标测与消融。 展开更多
关键词 期前收缩/室心动过速 心电图 射频导管消融 二尖瓣环
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室性心动过速的动态心电图分析
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作者 陈海英 王兴中 《浙江中医药大学学报》 CAS 2009年第6期851-852,共2页
临床心脏电生理检查,作程序心室刺激虽可诱发出室性心动过速,但不一定能捕捉到自发性室性心动过速,而应用动态心电图在检出室性心动过速有其优势。本文对动态心电图记录到的短程阵发性室性心动过速(VT)进行重点分析,
关键词 心动过速/室性 病因 诊断
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静脉注射胺碘酮治疗急性心肌梗死伴持续性室速和室颤 被引量:1
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作者 张雪羽 《河北北方学院学报(医学版)》 2009年第6期22-23,共2页
目的:观察静脉注射胺碘酮治疗急性心肌梗死伴持续性室速和室颤的疗效。方法:对急性心肌梗死突然发作持续性室速和室颤的9例患者,在非同步电转复的同时静脉注射胺碘酮150mg,无效者10min后再重复一次,继之以0.5-1.5mg/min静点维持24-36h... 目的:观察静脉注射胺碘酮治疗急性心肌梗死伴持续性室速和室颤的疗效。方法:对急性心肌梗死突然发作持续性室速和室颤的9例患者,在非同步电转复的同时静脉注射胺碘酮150mg,无效者10min后再重复一次,继之以0.5-1.5mg/min静点维持24-36h,同时口服胺碘酮,观察其疗效和副作用。结果:9例病人在用药的24h内持续性室速和室颤全部得到控制,1例出现一过性窦缓,无1例死亡。结论:初步观察认为静注胺碘酮治疗急性心肌梗死并持续性室速和室颤安全有效,可提高急性心肌梗死的抢救成功率。 展开更多
关键词 胺碘酮 心肌梗死 心动过速/室性 颤动
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ECPR患者ECMO支持早期发作室颤/室速与预后关系
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作者 周浩 李伟 +3 位作者 朱轶 张忠满 陈旭锋 吕金如 《南京医科大学学报(自然科学版)》 CAS 北大核心 2023年第12期1656-1662,1706,共8页
目的:回顾分析体外心肺复苏(extracorporeal cardiopulmonary resuscitation,ECPR)患者在体外膜肺氧合(extracorpo⁃real membrane oxygenation,ECMO)早期(72 h内)的室颤/室速(ventricular fibrillation/ventricular tachycardia,VF/VT)... 目的:回顾分析体外心肺复苏(extracorporeal cardiopulmonary resuscitation,ECPR)患者在体外膜肺氧合(extracorpo⁃real membrane oxygenation,ECMO)早期(72 h内)的室颤/室速(ventricular fibrillation/ventricular tachycardia,VF/VT)发生率、危险因素及对预后的影响。方法:纳入2017年1月—2023年3月南京医科大学第一附属医院急诊中心的ECPR患者,根据ECMO运行72 h内是否发作VF/VT分为VF/VT组和nVF/VT组,回归分析ECMO支持下VF/VT发作的危险因素,并探究VF/VT对临床预后的影响。结果:95例患者,年龄(50.02±15.93)岁,其中男66.32%,28 d存活率51.58%,VF/VT的发生率为33.33%。组间比较显示,nVF/VT组持续性肾替代治疗使用率、ECMO启动时间、乳酸均高于VF/VT组,VF/VT肌钙蛋白T(troponin T,TnT)呈高水平趋势;VF/VT组的pH值显著低于nVF/VT组。逐步法多因素Logistic回归显示,发生VF/VT后,TNT维持高水平的风险显著增大(OR=18.156,95%CI:3.620~91.059);ECMO启动时间延长(OR=1.118,95%CI:1.060~1.180)和pH值下降(OR=0.005,95%CI:0.000~0.953)是VF/VT发生的独立危险因素。结论:在ECPR患者中,严重酸中毒或ECMO启动时间延长的患者在ECMO支持72 h内发生VF/VT的风险明显增加,VF/VT发作并不影响主要临床预后,但可能会加重心肌损伤。 展开更多
关键词 体外心肺复苏 体外膜肺氧合 颤动/室心动过速 预后
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CHANGES OF PLASMA ENDOTHELIN AND ATRIAL NATRIURETIC PEPTIDE DURING THE ONSET AND AFTER TERMINATION OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA 被引量:1
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作者 李春盛 田茹敏 +3 位作者 朱丽楠 李丹宇 冯启刚 高秀兰 《Chinese Medical Sciences Journal》 CAS CSCD 1995年第3期161-164,共4页
Radioimmunoassays were used to measure the concentration changes of plasma endothelin(ET) and atrial natriuretic peptide(ANP) during the onset and after termination of paroxysmal supraventricular tachycardia(SVT). 30 ... Radioimmunoassays were used to measure the concentration changes of plasma endothelin(ET) and atrial natriuretic peptide(ANP) during the onset and after termination of paroxysmal supraventricular tachycardia(SVT). 30 cases were reviewed and compansons with 42 normal subjects were made. There are very significant differences(P<0.0001) in the concentration changes of both plasma ET and ANP during the onset and 30 minutes after the termination of SVT. During the onset period of SVT. the plasma ET and ANP were markedly elevated and 30 minutes after its termination they were lowered significantly, but their concentrations were still 2-fold higher than ihose of the control group. As the biological effects of ANP and ET are antagonistic to each other. their parallel elevation and lowering of plasma concentrations during and.after the termination of SVT reveal that these 2 hormones parucipate in the pathophysiological process of SVT. This phenomenon is possibly one of the homeostatic regulatory functions in the organism. 展开更多
关键词 paroxysmal supraventricular tachycardia ENDOTHELIN atrial natriuretic peptide
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RADIOFREQUENCY ABLATION OF IDIOPATHIC RIGHT VENTRICULAR TACHYCARDIA
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作者 华伟 JituBohra 《Chinese Medical Sciences Journal》 CAS CSCD 1998年第1期37-41,共5页
This paper presents our experience with radioreqencey ablation (RFA) for idiopathic ventricular tachycardia (VT) arising from right ventricle in 12 patients (pts.). The age range of patients was 21-50, with a mean of ... This paper presents our experience with radioreqencey ablation (RFA) for idiopathic ventricular tachycardia (VT) arising from right ventricle in 12 patients (pts.). The age range of patients was 21-50, with a mean of 38.5 years. Ten out of 12 were females, 1 patient had candia failure due to almost incessant VT while the rest had normal left ventricular function. Twelve pts had VT arising from the right ventricle; of those, 9 were from the outflow truct, 2 from the RV apex, and 1 from the RV inflow. In all pts the diagnostic study and therapeutic RFA were combined in a single procedure. Pacemapping and local activition time were used to guide the site of RFA in pts with VT arising from the right ventricle. RFA was successful in 11 of the 12 pts(91 % ). Number of RF applications were 1 -27, mean 9. 6;fluo- roscopy time were 4-75, mean 26. 9 minutes. RFA for idiopathic RV has a high success rate. This mode of treatment should be considered as a nonpharmacological curative treatment for symptomatic pts. 展开更多
关键词 radiofrequency ablation idiopathic VT right ventricle
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