射频消融治疗特发性室性心动过速9例临床报告

目的观察射频消融技术治疗特发性室性心动过速 (IVT)的临床效果。方法根据发作IVT时的体表 12导联心电图定位起源部位 ,行心内电生理检查 ,寻找稳定诱发IVT的条件 ,采用激动标测或 (和 )起搏标测相结合的方法标测靶点 ,对起源左心室间隔部的IVT寻找Purkinie电位 (p电位 ) ,标测靶点后放电消融。结果 11例呈RBBB图形伴电轴左偏或重度右偏 ,靶点在左心室间隔面中、下部 ,10例找到p电位。 7例为LBBB图形伴电轴不偏或右偏 ,靶点在右心室流出道 ;1例为LBBB图形伴电轴左偏 ,靶点在右心室流人道。l例IVT同时起源右室流出道的间隔部和游离壁 ,l例左心室特发性室性心动过速 (ILVT)合并房室结折返性心动过速的患者先消融房室结双径路 ,再行ILVT的消融。 1例右心室特发性室性心动过速 (IRVT)消融虽未立即成功 ,因延迟作用 3周后心动过速消失。消融成功患者的临床症状消失 ,未出现手术相关的并发症 ,随访期内所有病例存活。结论射频消融治疗IVT临床疗效肯定、成功率高、安全 ,应作为首选的根治方法。

Radiofrequency Catheter Ablation to Therapy Idopathic Ventricular Tach ycardia

Objective To observe the clinical effect of radiofrequency catheter ablation of idopathic ventricular taehycardia(IVT).Methods According to 12 leads exterior ECG during IVT to locate the originated site,after interior electrophysiology, looking for the condition to stablize IVT. To apply activation mapping combined with pace mapping to symbolize the target,to seek p potential of IVT originnated from left ventricular Septum,then symbolizing the target and ablation. Results 11 show RBBB with axis deviation left or severly right ,target are in mid or inferior part of left ventricular septum. 10 have p potentials. 7 show LBBB with no axis deviation or deviation right ,target are in the right ventricular flow. 1 shows LBBB with axis deviation left, originated from right ventricular flow. 1 IVT originnated spontaneously from septum and freewall of right ventricular flow. 1ILVT combined with atrioventricular nodal reentrant tachycardia was ablated dual atrioventricular pathys first, then ablated IVI.T. 1 IRVT was't succesful right now, IVT disappeared 3 weeks later. The suecesful cases have no clinical symtoms and complications, All cases survived during follow--up periods. Conclusions Radiofrequency catheter ablation is an effective technique in the treatment of idiopa: hic ventricular tachycardia with high successful rate and low occurrence of comlication, it can be selected as the first line treatment in patients with idiopathic ventricular tachycardia.