心室参考电极在特发性室性心动过速及室性早搏射频消融术中的应用

目的探讨以心室电极作参考标测消融靶点，指导特发性室性心动过速（室速）及顽固性室性早搏（室早）的射频消融治疗。方法将49例室速IVT及室早患者随机分为两组，治疗组25例，对照组24例。治疗组放心室电极指导标测，两组均采用激动标测和起搏标测法确定室速及室早的起源部位并进行射频消融治疗，比较两组消融成功率、标测时间、放电次数、放电时间、曝光时间、手术时间。结果两组即刻消融成功率分别为96％（24／25）和95．8％（23／24），差异无统计学意义；而标测时间、放电次数、放电时间、曝光时间、手术时间治疗组明显短于对照组（P〈0．05或P〈0．01）。结论在导管射频消融治疗特发性室性心动过速及顽固性室性早搏中，放置心室参考电极作指导，可缩短靶点标测时间并提高准确性，从而缩短射频消融时间。

Application of ventricular mapping electrode catheter in radiofrequency catheter ablation for idiopathic ventricular arrhythmia

Objective To study the role of ventricular mapping electrode catheter in the radiofrequency catheter ablation for idiopathic ventricular arrhythmia.Methods Forty nine patients with idiopathic ventricular tachycardia(IVT) and frequent ventricular premature contractions (PVCs),including 15 cases of IVT and 44 of PVCs,were divided into two groups randomly:the treatment group(n=25) and the control group(n=24).The ventricular mapping electrode catheters were set in the treatment group.Both groups were treated by radiofrequency catheter ablation (RFCA) with combining activation with pace mapping.Successful RFCA rate and the other parameters were compared between two groups after ablation.Results The immediate success rates of RFCA were 96%(24/25),95.8%(23/24),respectively,no significant difference between two groups.While the ventricular mapping electrode catheter used,the mapping time,the discharging time,the fluoroscopy time and the operation time were significantly shorter(P<0.05 or P<0.01,respectively),and the overall discharging number was significantly decreased(P<0.05).Conclusion Setting the ventricular mapping electrode catheter in the radiofrequency catheter ablation of idiopathic ventricular arrhythmia can help to shorten the operation time.