窦性心律下射频消融左后分支治疗左室特发性室速  

Catheter Ablation of Left Posterior Fassicular in Patients with Idiopathic Left Ventricular Tachycardia during Sinus Rhythm

作　　者：路军[1] 彭景添[1] 王梦洪[1] 吴友平[1] 张智亮[1] 

机构地区：[1]南昌大学第一附属医院心内科,南昌330006

出　　处：《江西医学院学报》2009年第12期70-72,共3页Acta Academiae Medicinae Jiangxi

摘　　要：目的评价以体表心电图出现左后分支传导阻滞图形为消融终点,在窦性心律下射频消融左心室特发性室速中的可行性。方法23例患者,男17例,女6例,年龄17～41岁[平均(26.92±8.5岁)],无器质性心脏病证据,均有阵发性心悸史,心动过速时心电图表现为右束支阻滞伴心电轴左偏。在窦性心律下于左侧室间隔前、中1/3处以PP电位与QRS电位融合的部位作为消融靶点,当体表心电图出现左后分支传导阻滞时,作为消融终点。结果23例患者均在窦性心律下消融,当体表心电图出现左后分支传导阻滞图形,ILVT不能被诱发。随访6～48(20.17±12.35)个月,无心动过速发作。结论在窦性心律下消融ILVT是安全的、有效的,以体表心电图出现左后分支传导阻滞为消融终点是可行的。Objective To evaluate the method of catheter ablation of left posterior fascicle（LPF） during sinus rhythm （SR） to treatment idiopathic left ventricular tachycardia （ILVT）.Methods Radiofrequency （RF） ablation was performed in 23 patients [17 male,6 female;mean age （26.92±8.5）years,aged from 17 to 41 years].All the patients had VT with surface ECG pattern of right bundle branch block（RBBB） configuration and left axis deviation and had no organic heart disease.We ablated at the inferior apical or mid-apical septum during sinus rhythm where a sharp fused PP before QRS complex was mapped.When the left posterior fascicular block in body ECG was observed,we had achieved the ablation endpoint.Results For all 23 patients,the ILVT was ablated at the inferior apical or mid-apical septum during the SR.When the left posterior fascicular block in surface ECG appeared,ILVT was not induced. All the patients were free of symptoms without antiarrhythmic drugs during a mean follow-up of 20.17±12.35 months （range,6 to 48 months）.Conclusion It is effective and safety to ablation ILVT during sinus rhythm. The left posterior fascicular block in surface ECG is used as an endpoint of RF ablation to treat ILVT is effective.

关 键 词：射频导管消融 室性心动过速 左后分支传导阻滞 

分 类 号：R541.71[医药卫生—心血管疾病]