单导管射频消融治疗右心室流出道源性心律失常

目的探讨单导管射频消融治疗右心室流出道源性心律失常的疗效与安全性。方法选择107例右心室流出道源性室性心律失常患者，其中室性心动过速12例，室性期前收缩95例。单点穿刺股静脉后，将单根消融导管按需放置于右心室心尖部、流入道或流出道。行电生理检查、起搏与激动顺序标测和消融治疗。结果消融成功101例，成功率94．39％。有效靶点电图较体表心电图QRS波群起始点提早（36．1±5．8）ms。成功靶点位于右心室流出道游离壁27例、后间隔26例、前间隔48例。操作时间（55．2±26．2）min，X线曝光时间（9．9±53）min，放电时间（418．2±163．6）s，术中无并发症发生。术后随访3月～3．5年，复发3例。结论单导管射频消融治疗右心室流出道源性室性心律失常安全、有效，操作简便，且节省费用。

Ablation of Arrhythmia Originating from Right Ventricular Outflow Tract by a Single Catheter

Objective To evaluate the effect and safety of ablation of arrhythmia from right ventricular outflow tract （RVOT） by a single catheter. Methods 107 cases with ventricular tachycardia （12 cases） and ventricutar premature beat（95 cases ） from RVOT underwent electrophysiological study, activation sequence mapping and catheter ablation by a single catheter through femoral vein. Results Ablation was successfully performed in 101 cases. The electrogram of effective target site was （36.1 ± 5.8） ms ahead of the onset of QRS complex on surface electrocardiogram. The successful sites located in free wall （ 27 cases ）, posteroseptal 126 cases） and anteroseptal （48 cases ） of RVOT. 3-he procedure time, fluoroscopy time and ablation time were （55.2 ±26.2）min, （9.9±5.3）min and （418.2 ± 163.6）s, respectively. No complication occurred during procedure and arrhythmia recurred in 3 cases during follow-up of 3 months to 3.5 years. Conclusion Arrhythmia from RVOT may be ablated effectively and safely by a single catheter.