特发性室性心动过速及室性期前收缩的射频消融治疗

目的探讨射频导管消融(radiofrequency catheter ablation,RFCA)治疗特发性室性心动过速(idiopathic ventricular tachycardia,IVT)和室性期前收缩(premature ventricualr contraction,PVC)可行性、必要性和疗效。方法回顾性分析16例IVT、PVC患者采用激动顺序标测和起搏标测法确定室性心动过速(ventricular tachycardia,VT)、PVC的起源部位并行RFCA治疗的资料。结果 3例IVT中2例起源于左室间隔部左后分支的蒲肯野系统,1例起源于右心室流出道(right ventricular outflow tract,RVOT)游离壁,同时合并另一种游离壁起源的PVC,3例消融均成功,1例复发。13例PVC中7例起源RVOT间隔部,3例起源于RVOT游离壁,1例同时存在两种形态PVC(分别起源于ROVT间隔部和游离壁),2例起源于左心室流出道,13例消融成功,1例复发。结论 RFCA治疗IVT及特定部位的PVC是安全、有效且成功率高的一种方法。

Radiofrequency catheter ablation of idiopathic ventricular tachycardia and premature ventricular contractions

Objectives To explore feasibility and necessity of radiofrequency catheter ablation (RFCA) treatment of idiopathic ventricular tachycardia (IVT) and premature ventricular contractions (PVC). Methods 16 cases of IVT, PVC treated with activation sequence mapping and pace mapping method to determine the origin of ventricular tachycardia (VT), PVC and treatment with RFCA. Results 3 cases of left ventricular IVT in the two cases originated in the left posterior branch of the left septal Purkinje system, one cases of right ventricular IVT originated from right ventricular outflow tract (RVOT) free wall, while the merger another free wall of the room of origin premature beats, 3 cases were successfully ablation, and 1 recurrence. 13 cases of PVC in 7 cases of septal RVOT origin, and 3 cases originated in the RVOT free wall, 1 case the existence of two forms PVC (to origin ROVT septal and free wall), two cases originated in the left ventricular outflow tract, 13 cases of successful ablation, 1 patient relapsed. Conclusions RFCA treatment of specific parts of the IVT and PVC is safe, effective, and high rate of success in a way.