特发性室性心动过速靶点标测与射频消融方法研究  

Study of target site mapping and radiofrequency catheter ablation (RFCA) for idiopathic ventricular tachycardia (IVT)

作　　者：吴书林[1] 杨平珍[1] 李海杰[1] 陈泗林[1] 郑祥生[1] 欧阳非凡[1] 詹贤章[1] 方咸宏[1] 林纯莹[1] 

机构地区：[1]广东省人民医院广东省心血管病研究所

出　　处：《中国介入心脏病学杂志》1999年第2期61-63,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的探讨特发性室性心动过速（ＩＶＴ）有效靶点标测与射频导管消融（ＲＦＣＡ）放电方法。方法６７例ＩＶＴ病人行ＲＦＣＡ治疗。右室ＩＶＴ（ＩＲＶＴ）和左室ＩＶＴ（ＩＬＶＴ）采用激动标测和起搏标测相结合方法寻找靶点，右室流出道（ＲＯＴ）ＩＲＶＴ用双大头导管交替标测或放置１根４极或１０极电极导管于ＲＯＴ作为参考电极。采用预设６０～７０℃渐增功率温控放电进行消融。结果６７例ＩＶＴ消融成功６２例，成功率９２．５％，其中２３例ＩＲＶＴ成功２１例，１例靶点位于右室流入道，消融成功，２２例位于ＲＯＴ，２０例消融成功；４４例ＩＶＴ成功４１例，１例靶点位于左室游离壁，消融成功，４３例位于左室室间隔部，４０例成功。４例术后出现少量心包积液。结论激动标测和起搏标测相结合是提高ＩＶＴ消融成功率的有效方法。渐增功率温控放电安全可靠。Objective The purpose of this study was to investigate the effective methods used to map the site of origin of IVT and the efficacy of RFCA for IVT Methods 67 consecutive patients (17 to 72 years old) presenting with IVT were enrolled in this study The site of origin of both right and left IVT (or IRVT and ILVT) was mapped using activation mapping during tachycardia and by pace mapping IRVT originated from right outflow tract (ROT) was mapped with two large tipped catheters, or with four polars or ten polars electrode as a reference During ablation procedure, we used the methods of preselecting a temperature of 60～70℃ and increasing slowly the generator power Results RFCA was successful in 62 of the 67 patients with IVT (92 5%), 21 of the 23 patients with IRVT, 41 of the 44 patients with ILVT The origin of IRVT was separately located in the ROT in 22 patients and in the right inflow tract in one patient The origin of ILVT was separately located in the left ventricular septum in 43 patients and in the free wall of the left ventricule in one patient Four patients with IVT were complicated with little pericardial efflusion after RFCA Conclusion The combination with using activation mapping and pace mapping was highly effective for RFCA for IVT The method of the radiofrequency energy discharge by generator with temperature control was safe in patients with IVT

关 键 词：心动过速 标测 射频导管消融 

分 类 号：R541.710.5[医药卫生—心血管疾病]