起源于左室流出道的频发性室性早搏射频消融治疗  

Radiofrequency catheter ablation of frequent ventricular pre-mature contractions from left ventricular outflow tract

作　　者：覃绍明[1] 邓金龙[1] 林英忠[1] 吴隐雄[1] 覃丽萍[1] 

机构地区：[1]广西壮族自治区人民医院心内科,广西南宁530021

出　　处：《心血管康复医学杂志》2007年第4期366-369,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:观察左室流出道频发室性早搏的射频消融治疗效果。方法:8例频发室性早搏患者,药物治疗无效,采用激动标测和起搏标测法确定室性早搏的起源部位,并行射频消融治疗。结果:8例患者7例射频消融成功。7例中6例在主动脉瓣下方的左室流出道记录到提前(31±8)ms的心室激动,室性早搏形态与起搏心电图12导联QRS波形完全相同者5例,11导联相同者1例;1例在左冠窦内记录到提前33ms的心室激动,属左室流出道室性早搏特殊类型,消融成功。随访3～21个月未复发。1例左室流出道早搏因多处标测未找到理想的靶点,消融失败。结论:射频消融治疗左室流出道室性早搏安全有效。　Objective：To observe the results of radiofrequency catheter ablation for frequent premature ventricular contractions（PVCs）originating from left ventricular（LV）outflow tract and to evaluate its feasibility and safety.Methods：Severely symptomatic frequent PVCs in eight patients were refractory to antiarrhythm drugs.Radiofrequency catheter ablation was performed in these patients when the site of PVCs origin was identified with pace mapping technique and activation-mapping.Results：Radiofrequency catheter ablation was success in seven patients.In which,a local activation time（31±8）ms earlier than the onset of PVCs on site of left ventricular outflow tract just beneath the left aortic valve was recorded in six patients,and 12-lead pace mapping ECG demonstrated concordance with the PVCs in 11-lead（one patient）to 12-lead（five patients）;in a patient,a local activation time 33 ms earlier than the onset of PVCs was recorded in the aortic sinus.PVCs were not inducible in seven patients successfully performed radiofrequency ablation.During a follow up period of 3～21 months,no PVCs recurrence in this seven cases,and the symptoms of the patients was significantly improved.One patient with PVC origininating from LV outflow tract failed to radiofrequency catheter ablation because no find ideal ablation target.Conclusion：Radiofrequency catheter ablation is a safe and effective treatment for patients with frequent premature ventricular contractions originating from left ventricular outflow tract.

关 键 词：室性早搏复合征 心室 导管消融术 

分 类 号：R654.2[医药卫生—外科学]