特发性室性期前收缩的射频导管消融治疗与随访  

Radiofrequency Catheter Ablation of Idiopathic Premature Ventricular Contractions

作　　者：李进[1] 张文武[1] 郑程[1] 李岳春[1] 林佳选[1] 杨鹏麟[1] 林加锋[1] 

机构地区：[1]温州医科大学附属第二医院心内科,325027

出　　处：《心电与循环》2013年第5期373-381,共9页Journal of Electrocardiology and Circulation

摘　　要：目的探讨特发性室性期前收缩(PVCs)的心电图特点,射频导管消融(下称消融)的疗效及安全性。方法 351例特发性PVCs患者接受消融治疗,采用普通温控消融导管以起搏标测结合激动顺序标测下消融。以PVCs消失且静脉滴注异丙肾上腺素不能诱发为消融终点;术后1个月、6个月、1年和2年行24h动态心电图检查。结果 291例起源于右心室(女性67.8%),60例起源于左心室(男性60.0%),其中以右心室流出道起源最多,其次为邻近三尖瓣环、主动脉窦和左心室室间隔起源。左、右心室起源的PVCs即刻成功率分别为80.0%和93.5%;随访2年,失访31例,复发13例。结论消融治疗PVCs是安全有效的,心脏不同部位PVCs的心电图特征及消融成功率有差异。Objective To explore EGG characteristics of idiopathic premature ventricular contractions （PVCs）and the efficacy and safety of radiofrequency catheter ablation （RFCA）. Methods 351 patients with symptomatic PVCs under- went RFCA. Ablation was performed by a catheter with temperature control guided by pace mapping and activation se- quence mapping. The end point of the procedure was that PVCs disappeared and could not been induced by intravenous isoproterenol. 24-hour Holter monitor was performed at 1 month, 6 month, 1 year and 2 year, respectively, after operation. Results 291 cases（67.8% female）had PVCs from right ventricle and 60 cases from left ventricle（60.0% male }. The ma- jority of PVCs originated from right ventricular outflow tract, the rest from tricuspid annulus, aortic sinus and left ventricular septum. The success rate of ablation of PVCs from left and right ventricle were 80.0% and 93.5%,respectively. 13 cases had PVCs recurred in 2 years and 31 cases were lost to follow-up. Conclusion RFCA of PVCs is safe and effective. The ECG features and ablation success rate vary with origins of PVCs.

关 键 词：特发性PVCs 射频导管消融 电生理学 

分 类 号：R541.7[医药卫生—心血管疾病]