心底部起源室性早搏导管射频消融的延迟愈合  

Delayed healing of radiofrequency ablation of premature ventricular contractions originating from the cardiac base

作　　者：连敏 孙育民[2] 张必利 LIAN Min;SUN Yumin;ZHANG Bili(Department of Cardiology,Changhai Hospital,Naval Military Medical University,Shanghai 200433;Department of Cardiology,Jing'an District Centre Hospital Af filiated to Fudan University,Shanghai 200040,China)

机构地区：[1]海军军医大学附属长海医院心内科,上海200433 [2]复旦大学附属静安区中心医院心内科,上海200040

出　　处：《国际心血管病杂志》2018年第6期363-366,共4页International Journal of Cardiovascular Disease

基　　金：上海市卫计委课题面上项目(201640242);上海市医学重点专科建设项目(ZK2015B13);上海市静安区卫生计生系统十百千卫生人才培养项目(JWRC2014D02)

摘　　要：目的:探讨导管射频消融室性早搏(室早)急性失败而发生延迟愈合的现象。方法:回顾性分析3例心底部起源室早行导管射频消融后出现延迟愈合患者的相关资料。结果:3例均即刻消融失败。病例1,女,69岁,术前24 h动态心电图示室早19 241次,术中消融部位为右室流出道后壁,术后第3天、1个月及6个月复查24 h动态心电图,室早分别为84次、124次和112次。病例2,男,62岁,术前室早22 305次,术中消融部位为右室流出道和右冠状动脉窦,术后第3天、1个月及6个月复查,室早分别为4次、12次和6次。病例3,男,68岁,术前室早为28 709次,术中消融部位为三尖瓣环高位间隔,术后第3天、1个月及6个月复查,室早分别为512次、408次和626次。结论:非左室顶部起源的室性心律失常有可能存在导管射频消融的延迟愈合效应。Objective:We investigated the delayed healing of radiofrequency ablation of premature ventricular contractions(PVCs).Methods:We retrospectively analyzed the data of 3 cases with the phenomenon of delayed healing of radiofrequency ablation of PVCs originating from the cardiac base.Results:All 3 cases had a failed ablation procedure.Case 1 was a female patient with 69 years old.On Holter monitoring,a total of 19 241 PVCs originating from the posterior wall of right ventricular outflow tract was recorded before ablation,which was reduced to 84,124 and 112 at 3 days,1 and 6 months,respectively,after the procedure.Case 2,a 62-year-old man,had a total of 22305 PVCs on Holter before ablation,which originated from right ventricular outflow tract and right coronary sinus,and was decreased to 4,12 and 6 at 3 days,1 and 6 months,respectively,after the procedure.For Case 3,the 68-year-old man had 28 709 PVCs originating from the high septal side of tricuspid annulus on Holter before ablation.The number of PVCs was reduced to 512,408 and 626 at 3 days,1 and 6 months,respectively,after the procedure.Conclusions:Ventricular arrhythmias originating far away from the left ventricular summit may also portend delayed healing efficacy of catheter radiofrequency ablation.

关 键 词：室性早搏 射频消融 延迟愈合 

分 类 号：R541.7[医药卫生—心血管疾病]