窦性心律下射频导管消融起源于希蒲系统特发性室性心动过速的临床观察

目的:探讨窦性心律下射频导管消融(RFCA)起源于希蒲系统特发性室性心动过速(IVT)的临床结果.方法:23例起源于希蒲系统IVT,按消融方法分为两组:(1)心动过速消融组,为9例患者,以心动过速下最早提前P电位为靶点,在心动过速下进行消融;(2)窦性心律消融组,为14例患者,以心动过速下记录最早P电位且窦律下试放电过程中出现同形或近似室性早搏及短阵室性心动过速为靶点,在窦律下进行消融.术后反复程序刺激不能诱发心动过速为消融终点.观察两种不同消融方法的临床结果.结果:两组在手术成功率、手术时间、X线曝光时间、并发症发生率及复发率方面无明显差别.结论:窦性心律下射频消融起源于希蒲系统IVT安全、有效.

Study the Clinical Results of Radiofrequency Catheter Ablation on Idiopathic Ventricular Tachycardia from His- Purkinje System During Sinus Rhythm

Objective: Study the clinical results of radiofrequency catheter ablation on idiopathic ventricular tachycardia from His - Purkinje system during sinus rhythm. Methods: 23 idiopathic ventricular tachycardias, from His - Purkinje system, were divided into two groups in accordance with radiofrequency catheter ablation methods: (l)Tachycardia ablation group, There are 9 patients, whose abltion target sites are the earliest P potentials during IVT. And this group was ablated during tachycardia. (2)Sinus rhythm group, there are 14 patients, whose ablation target site are the earliest P potentials during tachycardia, and the ventricular prematures and ventricular tachycardias, which have same figure with the IVTs, appear when ablation begins during sinus rhythm. And this group was ablated during sinus. The ablation is successful if tachycardia can not be induced. We investigated the clinical results of two different ablation methods. Results: There are no significant difference between success rate,process time,X ray time,complications and recurrence rate. Conclusion: It is effective and safe to ablate IVT from His - Purkinje system during sinus rhythm.