特发性室性心动过速射频消融治疗的临床研究  

Clinical study of radiofrequency ablation therapy in idiopathic ventricular tachycardia

作　　者：黎莉[1] 郑兆通[1] 钟敬泉[1] 张薇[1] 张运[1] 

机构地区：[1]山东医科大学附属医院心内科,济南市250012

出　　处：《岭南心血管病杂志》1999年第4期247-249,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的 总结17例特发性室性心动过速射频消融方法和结果。方法 左室特发性室速(Idiopathic Left Ventricular Tachycardia,ILVT)16例,右室特发性室速(IdiopathicRight Ventricular Tachycardia,IRVT)1例,15例ILVT采用标测V波前最早浦肯野纤维电位(P电位)方法,1例因室速不能诱发的ILVT和1例IRVT采用起搏标测。射频消融按常规方法进行。结果 射频消融治疗ILVT成功率为87.5％,IL-VT均起源于左室间隔面,有效消融靶点处P电位较体表心电图QRS波起始点提前(29.6±11.2)ms(20～55ms)。IRVT1例射频消融成功,有效消融靶点处起搏时与心动过速时的12导联心电图QRS波形完全相同。无1例出现并发症。结论 射频消融术是治疗特发性室性心动过速的安全有效方法。Objective To analyse the method and result of radiofrequency catheter ablation (RFCA) of idiopathic ventricular tachycardia. Methods 16 patients with idiopathic left ventricular tachycardia (ILVT) and 1 patient with idiopathic right ventricular tachycardia (IRVT) underwent RFCA to eliminate the ventricular tachycardia. Activation mapping were performed in 15 patients with ILVT. Pace mapping were used in patient with IRVT and 1 patient with ILVT in whom sustained ventricular tachycardia was not induced. Results RFCA was successful in 14 of the 16 patients (87.5% ) with IL-VT. The successful ablation sites were characterized by the Purkinje potential that 20 - 50 ms(29.6ms ± 11.2 ms) earlier than the onset of ORS during tachycardia. Activation and pace mapping studies disclosed the ILVT originated from the midseptum and inferior apical septum. Pace mapping produced same 12-lead ECG as spontaneous ventricular tachycardia in patient with IRVT and RFCA was successful. There were no complications during follow-up. Conclusion RFCA therapy is effective and safe in patients with idiopathic ventricular tachycardia.

关 键 词：室性心动过速 特发性 导管消融 射频电流 

分 类 号：R541.71[医药卫生—心血管疾病]