射频消融左后分支治疗维拉帕米敏感性特发性室性心动过速

目的报道消融左后分支治疗左室特发性室性心动过速(简称室速)。方法对57例维拉帕米敏感性左室特发性室速患者进行电生理检查及射频消融,以窦性心律时产生左后分支阻滞和/或室速不再被诱发作为消融成功终点。结果57例中41例室速诱发条件稳定(71.9%),9例诱发条件不稳定(15.8%),7例不能被诱发(12.3%),所有患者均达消融成功终点。术后全部患者体表心电图Ⅰ导联出现R波降低,S波加深,呈rS形态或RS形态,Ⅱ、Ⅲ、aVF导联出现小q波,或在原有q波基础上加深,R波振幅明显增高,呈qR形态,额面电轴度数显著增加(54.06°±38.24°vs 90.55°±7.88°,P<0.001)。27例出现完全性左后分支阻滞改变(47.4%),30例为不完全性左后分支阻滞(52.6%)。1例1年后室速再发,左后分支阻滞消失,重复消融直至再次出现左后分支阻滞,术后室速未有再发。结论射频消融产生左后分支阻滞可作为左室特发性室速的消融成功终点,尤其适用于不易被常规电生理检查诱发的患者。

Catheter ablation of left posterior fascicular in patients with verapamil-sensitive idiopathic ventricular tachycardia

Objective To report the radiofrequency ablation applied to the left posterior fascicular in the treatment of idiopathic left ventricular tachycardia(ILVT). Methods Electrophysiological test and radiofrequency(RF) ablation were performed in 57 patients with verapamil-sensitive ILVT,and the left posterior fascicular block in surface electrocardiogram and/or the ventricular tachycardia was no longer inducible as an endpoint for successful RF ablation. Results Of 57 consecutive patients,41(71.9%) were induced s...