三维电解剖标测左右流出道室性早搏射频消融治疗的比较研究  

Transcatheter radiofrequency ablation of ventricular premature originating from left and right outflow tract by using three- dimensional electroanatomical system: comparison study

作　　者：于宏颖[1] 潘震华[1] 伊红艳[1] 任明霞[1] 刁秀娟 黎辉[1] 

机构地区：[1]黑龙江省大庆油田总医院心内科四病区,163001

出　　处：《介入放射学杂志》2014年第12期1033-1035,共3页Journal of Interventional Radiology

摘　　要：目的了解移行于V3导联流出道室性早搏(室早)心电图和三维激动标测图临床特点。方法回顾行分析17例流出道室早患者,根据消融结果分为右室流出道(RVOT)(间隔)组,左室流出道(LVOT)组,比较两组心电图和三维激动标测图特点。结果心电图,V2导联R波时间指数RVOT(间隔)与LVOT起源室早比较[0.32(0.23~0.42)比0.48(0.39~0.5)],差异有统计学意义(P<0.05)。三维激动标测图,10 m内激动区域RVOT(间隔)面积和周长明显小于LVOT[面积:1.2(0.5~2.2)比3.3(2.3~3.8),P<0.05],[周长4.3(2.8~5.8)比7.9(7~9.5),P<0.05];且10 m内激动区域RVOT(间隔)呈纵轴大于横轴,与LVOT长轴/短轴比例[1.04(0.96~1.12)比0.49(0.42~0.56),P<0.05]。结论对于移行于V3导联流出道室早,心电图V2导联R波时间指数与三维激动标测图10 ms激动区域形状,面积,周长均有助于于判断位置起源。Objective To study the features of ECG and 3D activation mapping of ventricular premature originating from left and right outflow tract on V3 transition. Methods A total of 17 patients with ventricular premature originating from outflow tract were enrolled in this study. According to radiofrequency ablation resuhs the patients were divided into right ventricle outflow tract （RVOT） group and left ventricle outflow tract （LVOT） group. The features of ECG and 3D activation mapping were analyzed and the results were compared between the two groups. Results ECG analysis showed that significant difference in R-wave duration ratio on V2 lead existed between RVOT group and LVOT group E0.32（0.23 - 0.42） vs. 0.48 （0.39 - 0.5） ], the difference was statistically significant （P 〈 0.05）. The activation mapping analysis indicated that the l0- ms isochronal map area and circumference of RVOT group were significantly smaller than those of LVOT group [area： 1.2（0.5 - 2.2） vs. 3.3（2.3 - 3.8）, P 〈 0.05; circumference： 4.3（2.8 - 5.8） vs. 7.9（7 - 9.5）, P 〈 0.05]. The longitudinal-to-perpendicular axis ratio of R^OT group was significantly smaller than that of LVOT group [1.04 （0.96 - 1.12） vs. 0.49 （0.42 - 0.56）, P 〈 0.05]. Conclusion The R-wave duration ratio on V2 lead, the 10- ms isochronal map area and circumference, and the longitudinal- to- perpendicular axis ratio can accurately predict the ventricular premature origin on V3 transition. （J Intcrvent Radiol, 2014, 23： 1033-1035）

关 键 词：流出道室性早搏 三维标测系统 

分 类 号：R541.75[医药卫生—心血管疾病]