射频消融治疗右室流出道起源室性心律失常的临床分析  

Clinical analysis of radiofrequency ablation treatment for ventricular arrhythmias originating from right ventricular outflow tract

作　　者：温旭涛[1] 谭海斌[1] 杨希立[1] 许兆延[1] 李健民[1] 黄欢愉[1] 

机构地区：[1]佛山市第一人民医院心内科,广东佛山528000

出　　处：《临床心血管病杂志》2015年第10期1082-1085,共4页Journal of Clinical Cardiology

摘　　要：目的:总结射频消融治疗右室流出道起源的室性心律失常的疗效、安全性;分析其ECG特征及心脏转位对其初步定位的影响。方法:入选右室流出道起源的室性心律失常射频消融患者246例,其中顺钟向转位30例,逆钟向转位99例,通过同步12导联ECG,分析ECG特征及进行初步定位,在Ensite velocity 3.0Nav标测系统指导下,结合激动标测、起搏标测进行靶点定位消融。结果:本组手术成功率为96.3%,复发率3.7%,并发症发生率0.4%,右室流出道起源室性心律失常的ECG有一定的特征性。结论:射频消融治疗右室流出道起源的室性心律失常是有效及安全的;体表发作图分析对其初步定位有一定帮助;心脏转位对于ECG初步定位鉴别右室流出道起源部位(间隔部/游离壁)没有影响。Objective：To report the efficacy and safety of ablation treatment for ventricular arrhythmias originating from the right outflow tract;to analyze the influence of ECG characteristics and heart rotation on the initial positioning.Method：We selected 246 ablationed patients with ventricular arrhythmias originating from the right outflow tract,including 30 cases with clockwise rotation and 99 cases with,counterclockwise rotation.The ECG characteristics and initial positioning were analyzed by synchronous 12-lead ECG.Ensite velocity 3.0Nav navigation combined with active mapping and pacing mapping were used to determine the ablation target.Result：The successful rate was 96.3%,the recurrence rate was 3.7%,the complication rate was 0.4%.The ECG had certain characteristics.Conclusion：Radiofrequency ablation for ventricular arrhythmias originating from the right outflow tract is a effective and safe therapy.Analysis of the surface attack ECG is useful for initial position,and the heart rotation didn＇t effect on the initial positioning of ECG.

关 键 词：射频消融 右室流出道 室性心律失常 心脏转位 三维电解剖标测 心电图 

分 类 号：R541.7[医药卫生—心血管疾病]