左室特发性室性心动过速的射频消蚀治疗  

Radiofrequency catheter ablation of idiopathic left ventricular tachycardia

作　　者：马长生[1] 杨新春[1] 胡大一[1] 黄德嘉[1] 方全[1] 商丽华[1] 董建增[1] 刘旭[1] 孙英贤[1] 刘宣力[1] 王乐丰[1] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院心脏中心,华西医科大学第一附属医院心内科

出　　处：《中华心血管病杂志》1995年第1期21-24,共4页Chinese Journal of Cardiology

摘　　要：经导管射频消蚀治疗特发性左室室性心动过速（ＩＬＶＴ）缺乏大样本评价。该文介绍２６例ＩＬＶＴ病人行射频消蚀治疗的经验。２６例均为男性，年龄３６±１１岁。２１例在室速发作中行激动标测与消蚀，即在左侧室间隔寻找心室波前有较体表心电图ＱＲＳ波提前２０ｍｓ以上的高频、低幅电位或最早心室激动处为消蚀靶点；５例因导管机械刺激终止室速或室速诱发后不能持续而采用起搏标测。２６例病人全部一次消蚀成功，平均随访４个月，１例２个月后复发再治成功，无并发症。平均消蚀术时间１．６±１．１小时，Ｘ线照射时间２６±１６分钟，放电次数为４．０±１．８次，放电功率１０～３０Ｗ。成功消蚀靶点全部在间隔后半部分，主要位于间隔中部。结果表明射频消蚀治疗ＩＬＶＴ安全、有效，可作为这类病人的首选治疗。Abstract Twenty six consecutive patients with idiopathic left ventricular tachycardia and without structural heart disease underwent radiofrequency catheter ablation therapy. All of the patients were males with a mean age of 36 ±11 years. The QRS configuration during tachycardia was of right bundle branch block with left axis deviation in all patients. Activation mapping and ablation during tachycardia were taken in 21 of them. The successful ablation sites were characterized by an endocardial activation time of 20 milliseconds earlier than the onset of QRS during tachycardia and the earliest activation was preceded by an abnormal high frequency potential with low amplitude. Pace-mapping and ablation were taken in 5 patients by a pace-mapping QRS similar to or closely resembling that during tachycardia. Radiofrequency ablation was successful in all 26 patients (100%) in the first procedure. There were no complications. A mean follow-up of 4 months showed one recurrence with successful reablation.Conclusions: Radiofrequency catheter ablation therapy is effective and safe in patients with idiopathic left ventricular tachycardia. It should be considered as the primary therapeutic modality in these patients.

关 键 词：心动过速 室性 射频消融术 

分 类 号：R541.710.5[医药卫生—心血管疾病]