起源于主动脉左窦室性早搏的射频消融治疗

目的：探讨导管射频消融治疗起源于主动脉左窦室性早搏（室早）的方法和疗效。方法：对18例起源于主动脉左窦的室早患者行射频消融治疗。采用激动顺序标测，靶点V波较体表心电图QRS波群提前30～50ms，温控大头导管温度65℃～70C，放电240S。结果：靶点位于主动脉左窦左冠状动脉开口下方1～2cm，即刻成功率为100％。术中及术后无并发症发生。术后1个月内，18例患者复查动态心电图均仍见室旱，由术前（28157±1360）次／日降低为术后（856±310）次／日。术后1个月后，除4例器质性心脏病者仍见室早（697±263）次／日，其余患者室早消失。随访3～24个月无复发。结论：射频消融治疗起源于主动脉左窦的室早安全有效，器质性心脏病者也可以尝试射频消融治疗。

Radiofrequency catheter ablation of ventricular premature contractions originating from the left aortic cusp

Objective：To investigate the methods and results of radiofrequency catheter ablation （RFCA） of ventricular premature contractions （VPCs） originating from the left aortic sinus cusp （ACS）. Methods：The site of VPCs origin was identified with activation mapping in 18 patients. The earliest ventricular electrocardiogram at a successful ablation site was recorded 20～50ms before QRS onset. Temperature controlled radiofrequency catheter was used, the temperature was 65℃ 70C and the ablation time was 240s. Results：The successful ablation site was 1～2 cm under the debouch of left coronary. The immediate success ratio was 100% after RFCA. No complication occurred during and after RFCA. During one month after RFCA, VPC were still found in all the 18 patients by the method of ambulatory electrocardiogram testing （28157±1360） times/d before RFCA; （8S6±310） times/d after RFCA]. One month later after RFCA, VPC were still found （697 ± 263） times/d in 4 patients with organic cardiomyopathy, and not found in the others. No one recurred during the follow-up of 3～24 months. Conclusion：RFCA of VPCs is a safe and effective plan that can be used in some patients with organic eardiomyopathy.