期刊文献+

流出道室间隔肌壁内起源室性心律失常心电图特点与射频消融 被引量:2

Electrocardiogram characteristics and clinical effect of radiofrequency ablation on idiopathic ventricular arrhythmia originating from the intraventricular septum
下载PDF
导出
摘要 目的:分析流出道室间隔肌壁内起源特发性室性心律失常(IVAs)的心电图特征及导管消融体会。方法:对87例IVAs患者在Ensite三维标测系统指导下行导管射频消融的临床资料进行回顾性分析。结果:87例行导管射频消融术的IVAs患者,经激动和起搏标测,7例(8%)IVAs于心大静脉穿间隔支内标测证实起源点位于流出道室间隔肌壁内,心电图表现为左束支传导阻滞伴电轴向下图形。因消融导管无法通过心大静脉穿间隔支到达起源部位,选择在与起源点相对应的心内膜最早激动处进行消融,均未获得即刻成功;其中2例在随访3月内室早频率较前减少80%,获得远期成功。该起源部位IVAs的某些心电图和标测特征不同于其它部位起源。结论:流出道室间隔肌壁内起源IVAs某些心电图特征可帮助识别此类心律失常,并有助于指导导管消融标测,但消融成功率低。 Objective:To explore the characteristics of electrocardiography( ECG) and the clinical effect on idiopathic ventricular arrhythmias( IVAs) originating from the interventricular septum. Methods: The characteristics of ECG and clinical results of the Ensite mapping system under catheter ablation were analyzed in 87 patients with IVAs. Results:In a consecutive group of 87 patients with IVAs referred for ablation, the site of origin for ventricular arrhythmias was assessed by activation mapping and pace-mapping. In 7 out of 87patients(8%), an intramural focus in the interventricular septum was identified. All intramural ventricular arrhythmias manifested left bundle-branch block morphology with inferior axis. Due to the inaccessibility of the ablation catheter to the site via the venous system,radiofrequency energy was transmitted to the endocardial site where the earliest activations were recorded. Immediate success was not acquired in 7 patients; however, an 80% reduction of premature ventricular beats was found in 2 patients during the follow-up. ECG and mapping characteristics of the patients with intramural septal inventricular arrhythmias were different from those originating from other sites. Conclusion: Idiopathic septal ventricular arrhythmias may originate from interventricular septum. The distinctive ECG characteristics of IVAs can contribute to catheter mapping and ablation, but with lower success rate.
出处 《天津医科大学学报》 2015年第2期121-125,共5页 Journal of Tianjin Medical University
关键词 室性心律失常 室间隔 心电图 标测 射频消融 ventricular arrhythmia septum electrocardiography mapping catheter ablation
  • 相关文献

参考文献12

  • 1舒茂琴,钟理,冉擘力,宋治远,周扬,刘燕,朱平,李华康,张倩,刘建平,仝识非,景涛.流出道室性早搏/室性心动过速的导管消融疗效及体表心电图特征分析[J].中华心律失常学杂志,2012,16(5):352-356. 被引量:11
  • 2Yamada T, Okada T, Murakami Y, et al. Premature ventricular con- tractions arising from the intramural ventricular septum[J]. Pacing Clin Eleetrophysiol, 2009,32(10):e1.
  • 3Yokokawa M, Good E, Chugh'A, et al. Intramural idiopathic ventric- ular arrhythmias originating in the intraventricular septum mapping and ablation[J]. Circ Arrhythm Electrophysiol, 2012,5(2):258.
  • 4Tanner H, Hindrieks G, Schirdewahn P, et ah Outflow tract taehy- eardia with R/S transition in Lead V-3 - Six different anatomic ap- proaches for successful ablation[J]. J Am Coil Cardiol, 2005,45 (3): 418.
  • 5Yoshida N, Inden Y, Uehikawa T, et ah Novel transitional zone in- dex allows more accurate differentiation between idiopathic right ventricular outflow tract and aortic sinus cusp ventrieular arrhyth- mias[J]. Heart Rhythm, 2011,8(3):349.
  • 6Betensky B P, Park R E, Marchlinski F E, et al. The V (2) transition ratio: a new electrocardiographic criterion for distinguishing left from right ventricular outflow tract tachycardia origin[J]. J Am Coll Cardiol, 2011,57(22):2255.
  • 7Haqqani H M, Tschabrunn C M, Tzou W S, et ah Isolated septal sub- strate for ventricular tachycardia in nonischemic dilated cardiomy- opathy: incidence, characterization, and implications[J]. Heart Rhythm, 2011,8(8):1 169.
  • 8Stevenson W G, Soejima K. Catheter ablation for ventricular tachy- cardia[J]. Circulation, 2007,115(21):2750.
  • 9Aliot E M, Stevenson W G, Almendral-Garrote J M, et al. EHRA/ HRS expert consensus on catheter ablation of ventricular arrhyth- rajas:developed in a partnership with the European Heart Rhythm Association (EHRA),a registered branch of the European Society of Cardiology(ESC),and the Heart Rhythm Society(HRS);in collabora- tion with the American College of Cardiology (ACC)and the Ameri- can Heart Association(AHA) [J]. Heart Rhythm, 2009,6(6):886.
  • 10Tada H, Tadokoro K, Ito S, et al. Idiopathic ventricular arrhythmias originating from the tricuspid annulus: Prevalence, electrocardio- graphic characteristics, and results of radiofrequeney catheter abla- tion[J]. Heart Rhythm, 2007,4(1):7.

二级参考文献12

  • 1Ouyang FF, Parwis F, Siew YH, et al. Repetitive monomorphic yen- tricular tachycardia originating from the aortic sinus cusp. Electro- eardiographie characterization for guiding catheter ablation. J Am Coll Cardiol,2002,39 : 500 -508.
  • 2Lin D, Ilkhanff L, Gerstenfeld E, et al. Twelve-lead electrocardiol- graphic characteristics of the aortic cusp region guided by intracar- diac echocardiography and electroanatomic mapping. Heart Rhythm, 2008,5 : 663 - 669.
  • 3Tanner H, Hindricks G, Schirdewahn P, et al. Outflow tract tachy- cardia with R/S transition in lead V3: six different anatomic ap- proaches for successful ablation. J Am Coll Cardiol,2005 ,45 :418- 423.
  • 4Yukio S, Kazutaka A, Atsushi T, et al. Electrocardiographic and electrophysiologic characteristics of ventricular tachycardia origina- ting within the pulmonary artery. J Am Coll Cardiol.2005,45:887- 895.
  • 5Takumi Y, Thomas M, Harish D, et al. Idiopathic ventricular ar- rhythmias originating from the aortic root. J Am Coll Cardiol,2008, 52:731-739.
  • 6Siew YH. A anatomic insights for catheter ablation of ventricular tachycardia. Heart Rhythm ,2009,6 : S77-S80.
  • 7Miguel AA, Eduardo C, Alberto P, et al. Three-dimensional nonflu- oroscopic guidance for right coronary cusp ventricular tachycardia ablation. Heart Rhythm,2008,5 : 326-327.
  • 8Haris MH,Cory M. Isolated septal substrate for ventricular tachy- cardia in nonischemic dilated cardiomyopathy : Incidence, charac- terization, and implications. Heart Rhythm,2011,8 : 1169-1176.
  • 9Haris MH, Francis EM. Electroanatomic mapping and catheter ab- lation of ventricular tachycardia in arrhythmogenic cardiomyopa- thy. Cardiac Electrophysiol Clin,2011,3 :299-310.
  • 10舒茂琴,宋治远,冉擘力,仝识非,钟理,姚青,李永华,景涛,庄国强,刘建平,何国祥,胡厚源.特发性室性心动过速的导管射频消融治疗效果[J].第三军医大学学报,2008,30(5):441-443. 被引量:13

共引文献10

同被引文献11

引证文献2

二级引证文献3

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部