经三尖瓣瓣上与瓣下消融治疗右侧希氏束旁室性早搏的对比观察  

Catheter ablation of right side para-Hisian ventricular arrhythmias:above the septal leaflet of tricuspid valve compared with under the septal leaflet of tricuspid valve

作　　者：罗少玲 詹贤章[1] 刘方舟[1] 薛玉梅[1] 廖洪涛[1] 方咸宏[1] 梁远红[1] 魏薇[1] 廖自立[1] 刘洋[1] 林炜东 吴书林[1] LUO Shao-ling;ZHAN Xian-zhang;LIU Fang-zhou;XUE Yu-mei;LIAO Hong-tao;FANG Xian-hong;LIANG Yuan-hong;WEI Wei;LIAO Zi-li;LIU Yang;LIN Wei-dong;WU Shu-lin(Department of Cardiology,Guangdong Province Cardiovascular Institute,Guangdong General Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]广东省心血管病研究所心内科,广东省人民医院,广东省医学科学院,广东广州510080

出　　处：《中国心脏起搏与心电生理杂志》2018年第4期375-379,共5页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：广东省科技计划(2014B070705005);广州市科技计划(201508020261)

摘　　要：目的比较右侧希氏束旁室性早搏(简称室早)在三尖瓣瓣上与瓣下行导管射频消融的疗效性和安全性。方法选择于2010年5月至2017年12月间在广东省人民医院接受射频消融术治疗的右侧希氏束旁室早患者。回顾分析病历资料,将在三尖瓣下进行射频消融的患者纳入瓣下组,在三尖瓣上进行射频消融的患者纳入瓣上组,收集患者临床基线、电生理资料及长期随访结果。结果共50例纳入本研究,男性30例,女性20例。其中瓣下组21例,瓣上组29例。经导管射频消融治疗后,两组即时成功率无显著差别(90.5%vs 79.3%,P=0.276)。在随访中位时间为32个月后,瓣下组的远期成功率显著高于瓣上组(81.0%vs 48.3%,P=0.016)。结论射频消融是治疗右侧希氏束旁室早的有效手段;三尖瓣下消融治疗能显著提高患者的远期成功率。Objective To compare the safety and efficacy of catheter ablation of right side para-Hisian premature ventricular contractions （PH-PVCs）, by positioning the ablation catheter under the septal leaflet of tricuspid valve （TV） to positioning the ablation catheter above the septal leaflet of tricuspid valve. Methods The study reviewed the patients suffered from PH-PVCs and treated with radiofrequeney catheter ablation in Guangdong province cardi- ovascular institute between May 2016 and December 2017. Retrospective analysis of medical records, patients were categorized into ablation under the septal leaflet of TV group （un-TV group） and ablation above the septal leaflet of TV group （ab-TV group）. The clinical baselines, electrophysiological profiles, prognostic data and complications were collected and analyzed. Results Fifty patients were enrolled in present study. Twenty-one patients were en- rolled in un-TV group. During median follow-up of 32 months （1-89 months）, PVC free survival was 62.0% in all the patients. The un-TV group （81.0% vs. 48.3 %,P = 0.016） significantly improved long-term PVC free survival. Conclusion The long-term outcome after un-TV ablation strategy of PH-PVCs is positive. The un-TV ablation strategy significantly improves long-term PVC free survivaL[Chinese Journal of Cardiac Pacing and Electrophysi- ology, 2018,32 （4） ： 375 -- 379]

关 键 词：心血管病学 室性早搏 希氏束 导管消融 射频电流 

分 类 号：R541.7[医药卫生—心血管疾病] R454.1[医药卫生—内科学]