His束旁特发性室性早搏的心电图特点及射频消融  

Electrocardiogram characteristics and radiofrequency catheter ablation of premature ventricular contractions originating near the His-bundle

作　　者：谷宏越[1] 石铭宇[1] 梁兆光[1] 曲秀芬[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心内科,黑龙江哈尔滨150001

出　　处：《中国心脏起搏与心电生理杂志》2012年第4期295-298,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的回顾分析His束旁室性早搏(PVCs)的心电图(ECG)特点和射频消融方法。方法选择2005年至2011年5月间的7例His束旁的PVCs,并与136例起源于右室流出道(RVOT)的PVCs的12导联ECG进行对比分析并总结射频消融治疗的经验。结果与起源于RVOT的PVCs ECG对比,起源于His束旁PVCs的12导联ECG中aVL导联多表现为振幅较低,多以R波为主。V1导联多为QS型(85.7%),胸前导联移行区多发生于V2～V3导联(71.4%)。7例均在His束电极附近标测到最早心室激动。5例一次消融成功;1例1周后再次消融成功;1例因消融电极几乎与His电极重叠而放弃手术。结论 His束旁PVCs在体表ECG上完全可以进行鉴别,射频消融术可以根治此类PVCs。Objective To investigate electrocardiogram （ECG） characteristics of premature ventricular contractions （PVCs） originating near the His-bundle, and the methods of mapping and radiofrequeney catheter ablation. Methods Seven patients with PVCs originating near the His-bundle were selected since 2005. ECG variables were compared with 136 patients with PVCs originating from right ventricular outflow tract（RVOT）. All patients were underwent catheter mapping and radiofrequency ablation. Results Compared with PVCs originating from RVOT, ECG of PVCs originating near the His-bundle had a R wave in lead aVL, and a QS pattern in V1 （ 85.7% ） ,the precordial R-wave transition occurred at V2 -V3 （71.4%）. The earliest ventricular activation was observed close to the His-bundle in seven patients. Successful abla- tion was achieved in five patients at first time, one patient was ablated again after a week, the remaining one patient was not ablated, because the ablation catheter was overlapped to His-bundle electrode. Conclusion PVCs originating near the His-bundle have distinctive ECG characteristics,and radiofrequency catheter ablation can cure this kind of PVCs.

关 键 词：电生理学 His束 室性早搏 心电图 房室传导阻滞 

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