右心室室性心动过速的射频消融疗效与心脏超声结构特点的关系

目的 将射频消融成功和失败的右心室室性心动过速（right ventricular tachycardia,PVT）患者的心脏结构和心功能进行全面比较并将超声心动图发现与临床和电生理的资料联系起来。方法 射频消融成功患者15例为第1组，射频消融失败的患者9例为第2组，设正常人为对照组。应用二维、M型以及多普勒超声心动图测量心腔内径，评价心室形态、心室壁运动及左和右心室功能。结果 射频消融成功患者的右心室大小和功能的各超声值与正常对照组相比差异不显著，而射频消融失败患者右心室大小各值均大于正常对照组和射频消融成功的患者，右心室收缩功能各值均小于正常对照组和射频消融成功的患者，但两组室性心动过患者左心室各值均无明显异常。结论 射频消融失败的RVT患者右心室异常的情况呈多样性，有室腔扩张的整体异常，亦有易忽略的局部心室壁膨隆、运动减低，可能是心肌病发展过程中的不同阶段，即使轻微的右心室异常包括心室轻度扩大、心室壁运动轻度减低和局部心室壁膨隆，都可能降低射频消融的成功率。

The relationship between the efficacy of radiofrequency catheter ablation and the characteristics of echocar diographic findings in patients with right ventricular tachycardia

Objective The aim of this study is to reveal t he relationship between the efficacy of radiofrequency catheter ablation(RFC A)and the characteristics of echoca rdiographic findings in patients with ri ght ventricular tachycardia(RVT).Methods Twe nty four patients received echocardiogra p hic examination after the RFCA for RVT a nd were divided into two groups.Group 1 consisted of 15 patients who underwent s uccessful RFCA,group 2 included 9 patien ts who failed to ablation.Two dimension, M mode and Doppler echocardiographic stu dy were used to e valuate the chamber dimension,ventricula r wall motio n(VWM)and ejection fraction (EF)of right and left ventricle.Results When compared with norm al control group,there was no significan t difference of the mean values of dimen sion,VWM,as well as the EF of right vent ricle(RV)in group 1.In group 2, the RV dimension was greater and RV EF w a s lower than group 1 and control group.W hereas all measurements in left ventricl e remained no significant difference bet ween group 1 and group 2.Conclusio n Echocardiographic measurements a s well as global assessment scores of th e right and left ventricular demonstrate d a wide spectrum of right heart echocar diographic abnormalities in patients who se radiofrequency therapies failed, including changs ranging from overt abno r mal forms like a dilated chamber to conc ealed forms like swell and poor contract ion of local wall,probably representing different stages of the cardiomyopathic process.There are high successful rates in patients with no abnomal echocardiop hysic finding.The slight abnomal finding in right ventricule can reduce the succ essful rates of radiofrequency therapy.