室性心动过速合并室上性心动过速的射频消融

目的报道7例室性心动过速（VT）合并室上性心动过速（sVT）的射频消融。方法7例患者男6例，女1例，平均年龄（21±9）岁。阵发性心动过速病史（3．7±2．0）年。术中心房和心室刺激诱发VT和SVT，并进行消融。结果7例患者心房或心室刺激能反复诱发和终止VT合并SVT。法洛四联症矫治术后右心室VT合并三尖瓣环峡部依赖性心房扑动（AFL）1例，其余6例均为维拉帕米敏感性左心室特发性室速（ILVT），分别合并AFL1例，左后间隔旁路参与的顺向型房室折返性心动过速（AVRT）1例，冠状静脉窦口慢旁路参与的顺向型AVRT1例，慢慢型房室结折返性心动过速（AVNRT）1例，左侧游离壁旁路参与的顺向型AVRT2例。7例患者的两种心动过速均成功消融，所有患者消融术后随访2年，无一例VT或SVT复发。结论VT合并SVT并不少见，消融术中应放置必需的心腔内电极导管，完成详细电生理检查，避免漏诊。一次消融应根除两种疾病。

Radiofrequency ablation of coexisting ventricular tachycardia and supraventricular tachycardta

Objective To evaluate effects of radiofrequency ablation of coexisting ventricular tachycardia(VT)and supraventricular tachycardia(SVT)in patients.Methods Seven patients6 male,1 female,mean age(21±9)years old]with paroxysmal tachycardia for(3.7±2.0)years were included.All the 7 patients underwent electrophysiological study for induction of VT and SVT and radiofrequency ablation.Results Coexisting VT and SVT in 7 patients were easily reproducibly induced and terminated by atrial or ventricular stimulation.One patient with post-operation of correction of tetra logy fallout had coexisting right ventricular tachycardia and cavotricuspid isthmus-dependent flutter.The remaining 6 patients were all verapamil-sensitive idiopathic left ventricular tachycardia(ILVT)with coexisting AFL in 1 patient,orthodromic atrioventricular reentrant tachycardia(AVRT)in 4 (1 patient with a left posterior accessory pathway,1 patient with slow conduction accessory pathway in the ostium of coronary sinus.and 2 patients with accessory pathway in left free-wall)and slow-slow atrioventricular nodal reentrant tachycardia(AVNRT)in 1.All the tachycardias in 7patients were successfully ablated.All 7 patients were free from VT and SVT during 2 years follow-up.Conclusion Coexisting VT and SVT is not rare and two tachycardias must be all ablated in one procedure.Catheters inserted into heart cavity and detailed electrophysiological study are necessary.