射频消融治疗起源心室流出道室性早搏

目的:报道起源心室流出道频发室性早搏的导管射频消融治疗结果。方法:采用起搏标测与激动顺序标测结合的方法对23例非器质性心脏病患者频发室性早搏行射频消融治疗。结果:19例室早起源右室流出道,其中间隔部为13例,游离壁6例;4例室早起源于左室流出道,2例为左冠状动脉窦口内,2例为流出道主动脉瓣下。21例患者消融一次成功,平均放电(4.6±3.3)次。2例患者为二次消融成功。24h动态心电记录术前、术后室早总数为(20846±3288)次/24h和(102±62)次/24h(n=16,P<0.001),临床症状基本消失,无并发症,平均随访(12±4.5)个月。结论:起源心室流出道频发药物治疗无效的室性早搏可选择导管射频消融治疗。

Radiofrequency catheter ablation of ventricular premature beats ventricular outflow tract

Objective to report the results of radiofrequency catheter ablation for frequent ventricular ectopic beats originating from ventricular outflow tract.Method With activation mapping and/or pace mapping method,radio frequence catheter ablution was used to eliminated frequent monomorphic ventricular ectopic beats in 23 patients without structural heart disease.Results The site of origin was in right ventricular outflow tract in 19 patients and in left ventricular outflow tract in four patients.Radiofrequency catheter ablation was successfully ablated in 21 patients with mean 4.6±3.3 radiofrequency application,other two patients was successfully ablated in second times,the successful ratio was 91.4%.After ablated the number of ventricular ectopic beats was decreased from(20846±3288)beats/24 h to(102±62)beats/24 h,P<0.001.The patients' symptoms were almost disappeared,no complication encountered.During a mean follow up period of(12±4.5)months,no recurrence occurred in all patients.Conclusion Radiofrequency catheter ablation may be an alternative method to treat frequent ventricular ectopic beats originating from ventricular outflow tract in patients without structural heart disease.