特发性室性心动过速的射频消融

目的对经射频消融术证实的特发性室性心动过速的病例进行总结分析，探讨室性心动过速的发病状况、心电图特点、消融靶点的确定及消融结果。方法对32例特发性室性心动过速的起源部位和体表心电图进行分析，所有患者在诱发出室性心动过速后进行射频消融治疗，观察特发性室性心动过速的射频消融成功率和复发率，以及它们和消融靶点的关系。结果右室特发性室性心动过速心电图表现为左束支传导阻滞，左室特发性室性心动过速心电图则多表现为右束支传导阻滞。消融靶点的确定右室特发性室性心动过速主要采用起搏标测法，左室特发性室性心动过速主要采用激动顺序标测法。右室流出道室速组在起搏标测起搏ECG和VT时ECG的12导联QRS波完全相同处消融成功率较高。结论室性心动过速发作时的体表心电图可初步估计特发性室性心动过速的起源部位，射频消融术治疗特发性室性心动过速成功率高、并发症少。

Radiofrequency catheter ablation of idiopathic ventricular tachycardia

Objective To investigate the prevalence and twelve lead surface ECG features of idiopathic ventricular tachycardia and the localization of target site, as well as the effects of radiofrequency catheter ablation （RFCA）. Methods The originating sites, feature of twelve leads surface ECG, successful ablation rates, recurrence rates and successful ablation target were studied in thirty two patients with idiopathic ventricular tachycardia. Results The ECG of right ventricular tachycardia presented left bundle branch block and the left one mostly pre- sented right bundle branch block. Ablation target was localized by pace mapping and activation mapping. The target site of right ventricnlar tachycardia was mainly localized by pace mapping and the left one was mainly localized by activation mapping. The successful ablation sites of right ventricular out flow tract tachycardia were characterized by a pace mapping QRS closely resembling the ventricular tachycardia. Conclusion Twelve lead surfaced EGG may preliminarily estimate the originating site of idiopathic ventricular tachycardia. Radiofrequency catheter ablation is an effective technique in the treatment of idiopathic ventricular tachycardia with high successful rate and low occurrence of complication.