器质性心脏病室性心动过速导管消融治疗进展

器质性心脏病瘢痕相关性室性心动过速（室速）的发生主要是折返机制,目前多采用心脏三维标测系统指引下对耐受性好、血流动力学稳定的室速激动标测消融,对于血流动力学不稳定的室速,窦性心律下基质标测、电压图判断室速的解剖基质,结合起搏标测和拖带标测技术识别室速的折返环,盐水灌注导管消融治疗;近年来不断积累有关临床循证证据、适应证进一步拓展、新的标测消融和辅助技术临床上应用,取得了新的进展。

Developments in Catheter Ablation of Ventricular Tachycardia in Patients with Organic Heart Disease

The mechanism of ventricular tachycardia(VT) in organic heart disease is reentry within the scar and scar-border zone.Three dimensional mapping systems are often helpful for mapping,and irrigated ablation catheters are essential for linear ablation.Several mapping strategies are helpful in the scar-related VT.Activation mapping for hemodynamically tolerated VT,substrate mapping and voltage mapping for unstable VT,pace mapping and entrainment mapping determine putative VT exit sites and channels of slow cond...