特发性室性心动过速射频导管消融标测方法探讨

目的探讨特发性室性心动过速（IVT）的标测方法.方法对52例行射频消融的IVT患者进行标测.39例源于右心室的IVT采用消融导管右心室起搏标测法,以起搏时与室性心动过速（室速）发作时的12导联心电图QRS波形态与振幅完全相同的起搏部位为消融靶点.12例起源于左心室的IVT以发作时消融电极导管在左心室内标测到较体表心电图QRS波提前≥20 ms的最早高频低振幅电位为消融靶点（激动顺序标测法）,1例左心室室速采用起搏标测法.结果左心室IVT消融成功率100%（13/13）,右心室IVT消融成功率94.87%（37/39）.结论起源于左心室的IVT宜采用激动顺序标测法,起源于右心室的IVT宜采用起搏标测法.

Mapping methodology of radiofrequency catheter ablation on patients with idiopathic ventricular tachycardia

Objective To study mapping method of radiofrequency catheter ablation(RFCA)on patients with idiopathic ventricular tachycardia(IVT).Methods Fifty-two patients under gone RFCA were mapped.Right-ventricle-pacing method was performed on 39 cases with IVT originated from right ventricle.Ablation target site was determined when the 12-lead pacing electrocardiogram displayed QRS wave with the shape and amplitude identical to that of the IVT running.In 12 patients with IVT originated from left ventricle,activation sequence mapping was used,in order to detect a potential of high frequency and low amplitude using the ablation catheter,when the potential was the earliest of the QRS waves of standard surface electrocardiogram,at least 20 ms ahead,the ablation target site was determined.The pacing method was performed on 1 patient with idiopathic left ventricular tachycardia.Results Success ratio of RFCA was 100%(13/13)in idiopathic left ventricular tachycardia,and 94.87%(37/39)in idiopathic right ventricular tachycardia,respectively.Conclusions The activation sequence mapping method is suitable for patients with idiopathic left ventricular tachycardia and the pacing mapping method is suitable for patients with idiopathic right ventricular tachycardia.