CRT伴频发室早的射频消融疗效

目的回顾性研究射频消融治疗心脏再同步化治疗术后频发室性早搏的可行性和安全性。方法本中心5例心脏再同步化治疗（CRT）术后患者,24h动态心电图提示室性早搏负荷大于总心率的10%,给与心内电生理检查和射频消融术。结果 5例患者男性4例,女性1例,平均年龄48±13.43岁。4例患者被成功消融,即刻成功率为80%;随访12个月4例均无复发。4例成功消融患者随访6个月较术前比较,左心室射血分数（LVEF）明显增加（31.05±3.50%vs.23.00±2.94%,p〈0.05）、左室舒张末期内径（LVEDD）明显减小（60.50±5.06mm vs.68.00±6.37mm,p〈0.05）、左室收缩末容积（LVESV）明显减小（127.32±28.09vs.186.75±40.90,p〈0.05）。另1例患者术前和术后,各心脏超声参数无明显变化。无一例出现并发症。结论射频消融是一种有效的治疗CRT术后频发室性早搏的方法,同时也可以改善CRT术后无反应者疗效。

Radiofrequency ablation of numerous premature ventricular contractions in patients with cardiac resynchronisation therapy

Objective To study the effect and safety ofradiofrequency ablation of numerous premature ventricular contractions in patients who had received cardiac resynchronisation therapy （CRT） retrospectively. Methods In five CRT patients with PVC, more than 10% of the total heart rates in 24 hours in those who underwent electrophysiological examination and radiofrequeney ablation. Results Among 5 patients, with an average age of 48 ± 13.43 years, 4 cases were male, l wasfemale. Four patients （80%） obtained an immediate success ofablation, and no relapse was found in the 4 cases by 12 months follow up. Compared with preoperation through 6 months follow up, the four patients with successful ablation showed a significant increase of left ventricular ejection fraction （LVEE 31.05 ± 3.50% vs. 23.00 ± 2.94%, p 〈0.05 ） and a remarkable reduction of left ventricular end-diastolic diameter ONEDD, 60.50±5.06mmvs.68.00±6.37mm, p〈0.05） and left ventricular systolic volume （LVESV,127.32±28.09vs. 186.75 ± 40.90, p〈0.05）.Additionally, neither obvious changes of parameters of echocardiography nor complications were noted in the left one patient before and after operation. Conclusions Radiofrequency ablation is an effective therapy of frequent ventricular premature contractions after CRT and can improve CRT efficacy in the subjects who had no respondance to the operation.