左室特发性室性心动过速常规方法消融困难的线性消融  

Radiofrequency catheter linear ablation in idiopathic left ventricular tachycardia patients not amenable to standard mapping ablation strategies

作　　者：冯金忠[1] 吴峰[1] 骆合德[1] 邱一华[1] 周巍[1] 俞峰[1] 

机构地区：[1]解放军第98医院心内科,浙江湖州313001

出　　处：《心脏杂志》2011年第3期344-346,共3页Chinese Heart Journal

摘　　要：目的：探讨在常规方法消融困难的左室特发性室性心动过速（ILVT）患者中室间隔左室面线性消融的有效性。方法：18例术中不能诱发持续性心动过速或发作时不能耐受患者，进行室问隔左室面心尖到心底部连线的前l／3～1／2区域，在窦性心律下首先标到蒲肯野氏纤维电位（PP），向下至室间隔与左室下壁交界、向L至前后间隔中线进行线性消融，术后门诊或电话随访。结果：所有患者术后即刻均未能诱发}}jILVT。随访3～35（23±13）个月，3例／18例（17％）复发，远期成功率达83％，无l例发生永久性的并发症。结论：对于术中不能诱发持续性心动过速或发作时不能耐受的ILVT患者，室间隔左室面线性消融安全有效，可以作为补救性消融措施。AIM ： To investigate the efficacy of linear ablation in the left ventricular （ LV ） septum in patients with idiopathic left ventricular tachycardia （ILVT） who were not amenable to ＂ traditional ＂ mapping. METHODS： In 18 ILVT patients, non-inducible/nonsustained VT and those unable to tolerate VT, a linear lesion along the mid to inferior septum was placed perpendicular to the long axis of the ventrMe, approximately midway to one-third from the base to the apex in the region where the Purkinje potentials （PP） were recorded during sinus rhythm. RESULTS： During a follow-up of 22.8±12.6 months （range： 3 -35 months）, there were three recurrences of tachycardia in the 18 patients （ 16. 7% ）. Long-term achievement ratio was 83.3% with no permanent complications. CONCLUSIONS： Linear ablation in the septum of the LV as a substitute mapping strategy was effective and safe in ILVT patients, noninducible/nonsustained VT and those unable to tolerate VT.

关 键 词：心动过速 室性 左室 特发性 室间隔 左 蒲肯野氏纤维电位 导管消融 线性消融 

分 类 号：R541.71[医药卫生—心血管疾病]