零射线下应用倒U法联合普通弯法行射频消融治疗特发性右心室流出道室性期前收缩的效果分析  

The efficacy and safety of zero-fluoroscopy catheter ablation for idiopathic premature ventricular contraction originating from right ventricular outflow tract with reversed U-curve and conventional methods

作　　者：张涛[1] 王云龙[1] 梁卓[1] 韩智红[1] 赵华[1] 任学军[1] ZHANG Tao;WANG Yun-long;LIANG Zhuo;HAN Zhi-hong;ZHAO Hua;REN Xue-jun(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心内科,北京100029

出　　处：《中国介入心脏病学杂志》2019年第4期193-198,共6页Chinese Journal of Interventional Cardiology

摘　　要：目的探讨零射线环境下应用倒U法联合普通弯法行射频消融治疗特发性右心室流出道(RVOT)室性期前收缩(PVC)的有效性及安全性。方法入选2017年6月至2017年12月在首都医科大学附属北京安贞医院行导管射频消融的36例PVC患者,术前行体表心电图监测。术中借助三维标测系统和压力监测导管,在零射线下采用普通弯法激动标测RVOT,再采用倒U法激动标测肺动脉瓣上,并于最早激动点处行射频消融。结果 36例PVC患者于RVOT零射线消融成功,其中31例首先通过倒U法于肺动脉瓣上行射频消融(30例消融成功;1例消融无效,最终通过普通弯法于RVOT前间隔消融成功),其余5例首先通过普通弯法于RVOT消融(3例消融成功;2例无效,最终通过倒U法于肺动脉瓣上消融成功)。术后患者均无手术相关并发症发生,除1例患者外所有患者停用抗心律失常药物且无再次PVC发作。结论借助三维标测系统和压力监测导管,在零射线下应用倒U法联合普通弯法行射频消融治疗RVOT PVC是安全可行的。Objective This study aimed to investigated the efficacy and safety of zero-fluoroscopy catheter ablation for idiopathic premature ventricular contraction(PVC) originating from right ventricular outflow tract(RVOT) with reversed U-curve and conventional methods. Methods Data were analyzed from 36 patients undergoing catheter ablation of idiopathic PVC from June 2017 to December 2017 admitted to Beijing Anzhen Hospital. Under the guidance of 3-dimensional system and smart-touch catheter, RVOT was mapped with the conventional method and pulmonary artery was mapped by using reversed U-curve method without radiation exposure. Radiofrequency ablation was carried out at the earliest activation site.Results Thirty-six cases of PVC were successfully ablated in RVOT without radiation exposure and there were no any complications, including 31 cases of using reversed U-curve method based pulmonary artery ablation and 5 cases of using conventional method based RVOT ablation. Conclusions Under the guidance of three dimensional mapping system and smart-touch catheter, zero-fluoroscopy exposure was safety and feasibility to ablate PVC originating from RVOT with reversed U-curve and conventional methods.

关 键 词：室性期前收缩 射频消融 零射线 右心室流出道 倒U法 

分 类 号：R541.7[医药卫生—心血管疾病]