顽固性室性早搏的导管标测与射频消融治疗  

Curative Radiofrequency Catheter Ablation for Control of Refractory Symptomatic Ventricular Ectopic Activity

作　　者：杨延宗[1] 高连君[1] 张树龙[1] 杨东辉[1] 刘少稳[1] 丛培欣[1] 林治湖[1] 宋道岭[1] 

机构地区：[1]大连医科大学附属第一医院心内科

出　　处：《中国心脏起搏与心电生理杂志》1997年第1期22-25,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：采用射频导管消融术对症状明显、药物无效的１０例顽固性室性早搏（简称室早）进行治疗。将消融电极送至右室流出道区域，以Ｓ１Ｓ１或ＲＳ２早搏刺激标测到与体表１２导联心电图记录的自发室早ＱＲＳ波群图形完全相同，并且激动标测时自发室早的局部电图较体表心电图ＱＲＳ波群提前３０ｍｓ以上的部位为消融靶点。以室早在放电后１０ｓ内消失，维持稳定窦性心律３０～６０ｍｉｎ为即刻成功标准。９例患者经１０～２０Ｗ、消融６０～１８０ｓ，早搏和短阵室速完全消失；１例失败。平均随访１１个月，未服任何抗心律失常药物症状消失，复查心电图和动态心电图，９例中８例无早搏、１例为偶发室早，均无并发症。提示射频导管消融术是治疗某些右室流出道早搏的可行方法。Ten patients with the refractory symptomatic ventricular premature beats (VPBs) originating from right outflow tract were successfully treated with the radiofrequency catheter ablation (RFCA) technique.The target point were identified by both pace and activation mapping method.After 1 to 12 times of radiofrequency currents deliveries,the VPBs were completely abolished.During the following up of 2 to 24 months,all patients remained free from any symptoms on no medication.The ECG and Holter ECG showed no recurrence of VPBs in 8 cases,and occasional VPBs in 1.One failed.This report demonstrates that,in some cases,the arrhythmogenic substrate of the VPBs originating from right outflow tract can be easily suppressed by means of the RFCA technique,and the RS 2 pacing is a favorable mapping protocol in identifying the target point.

关 键 词：室性早搏 导管标测 射频消融 

分 类 号：R541.730.5[医药卫生—心血管疾病]