射频消融治疗右室流出道室性早搏的研究  

Radiofrequency catheter ablation of premature ventricular contractions from right ventricular outflow tract,

作　　者：谢义民[1] 贾海波[2] 严激[3] 

机构地区：[1]安徽省淮北市人民医院,235000 [2]南京市第一医院,210001 [3]安徽省立医院,230001

出　　处：《临床心电学杂志》2011年第2期96-98,共3页Journal of Clinical Electrocardiology

摘　　要：目的探讨射频消融治疗右室流出道室性早搏(RVOT-VPC)的临床效果和安全性。方法经常规体检、生化检查、X线胸片、心脏彩超、心电图等各种检查后入院。右室流出道室性早搏患者48例,采用起搏标测法,以心室起搏时12导联心电图与其临床室性早搏的图形完全一致作为消融靶点,以放电后:①早搏在10s内消失;②出现同形早搏先增多后消失;③出现短阵性同形室速为消融有效标志,以静滴异丙肾上腺素后30min内无右室流出道室性早搏出现为消融终点。结果 46例患者取得即刻成功,手术失败2例,术后随访发现消融成功患者临床症状均消失,所有病例无新的恶性心律失常发生。结论对药物治疗无效的无器质性心脏病的右室流出道室性早搏行射频消融治疗成功率较高,并发症少,并能显著改善患者临床症状,是一种安全有效的方法,该技术可进一步推广。Objective To explore the effectiveness and safety on radiofrequency catheter ablation of premature ventricular contractions from right ventricular outflow tract.Methods A total of 48 patients with premature ventricular contractions from right ventricular outflow tract were enrolled,pace mapping is used.Pace maps with identical matches of PVC morphology in all 12 surface ECG leads are indicative of the ablation target.The target of effect ablation include：1.PVC disappear in the 10s,2.A rapid ventricular reponse,followed by gradual slowing and complete resolution,3.appear identical QRS morphology to that of VT.successful ablation is defined as the noninducibility of VT with isoproterenol administation,during at least 30minutes after ablaton.Results 46 patients achieved immediate success,operation failed in 2 cases,postoperative clinical follow-up found that symptoms disappeared in successful ablation cases,and all cases no new malignant ventricular arrhythmia appear.Conclusion radiofrequency ablation of premature ventricular contractions from right ventricular outflow tract is a safe,effective technique.

关 键 词：射频消融 右室流出道 室性早搏 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]