摘要
目的探讨不同起源特发性室性期前收缩(PVCs)和(或)室性心动过速(VT)的射频导管消融(下称消融)治疗疗效及安全性。方法 828例PVCsNT患者接受消融治疗,采用X线影像或三维标测系统进行标测,普通或冷盐水消融导管进行消融,分析不同标测与消融方法治疗不同起源PVCs/VT的优缺点。结果右心室起源580例(70.05%),左心室起源248例(29.95%),其中右心室流出道最常见(469例,占56.64%),其次为左心室间隔部、左心室流出道、邻近三尖瓣环。左、右心室起源分别消融成功率分别为87.50%和95.52%。心内膜起源者采用普通温控消融导管消融,经冠状窦的心外膜消融则需应用冷盐水灌注导管。结论特发性PVCs/VT消融治疗安全有效,右心室起源者成功率更高。
Objective To explore the efficacy and safety of catheter radiofrequency ablation （RF）for idiopathic premature ventricular contraction （PVC） and ventricular tachycardia （VT） from different origins. Methods RF was performed with a conventional catheter or an irrigated- tip catheter in 828 patients with PVC/VT under the guidance of X- ray image or three- dimensional mapping systems. The advantage and disadvantage of different mapping and ablation strategies for different PVC/VT were analyzed. Results 580 cases had PVC/VT originating from right ventricle （70.05%） and 248 from left ventricle （29.95%）. Right ventricular outflow tract was the most common site （56.64%）, fol owed by left ventricular septum, left ventricular outflow tract and tricuspid annulus. Success rate of ablation was 95.52% for right ventricular origin and 87.50% for left ventricular origin. Conventional catheter with temperature control was used in endocardial ablation, and irrigated- tip catheter was required in epicardial ablation via coronary sinus ostium. Conclusion RF is safety and efficacy for idiopathic PVC/VT with a higher success rate for those from right ventricle.
出处
《心电与循环》
2015年第1期16-20,共5页
Journal of Electrocardiology and Circulation
基金
温州市重大科研项目(项目编号:Y2008086)
关键词
室性期前收缩
特发性室性心动过速
射频导管消融
Premature ventricular complexes
Idiopathic ventricular tachycardias
Catheter radiofrequency ablation
