右室流出道室性早搏的射频消融治疗

目的探讨射频消融治疗右室流出道室性早搏的方法和疗效。方法选择52例右室流出道室性早搏患者进行射频消融法治疗,男28例,女24例,年龄15~67岁,平均45.1岁;病史3~14年,平均6.8年均有明显症状,但无器质性心脏病的证据。多种抗心律药物治疗无效,心电图显示室性早搏均呈左束支阻滞图形,Ⅱ、Ⅲ、AVF导联为高大的R波。采用起搏标测。结果即刻成功率94%(49/52)。术前与术后1周24h动态心电图检查室性早搏为(11250~37460)次/24h和(0~1120)次/24h,两者间差异(P<0.01)。随访2~32个月,无复发。结论无器质性心脏病顽固性右室流出道室早的导管射频消融是一种安全可靠的方法。

Radiofrequency Catheter Ablation of Ventricular Ectopic Beat Originating in the Right Outflow Tract

Objective To appraise the efficacy and safety of radiofrequency catheter ablation(RFCA) for ventricular ectopic beat originating in the right ouflow tract.Methods Fifty-two patients(28 male and 24 female) were selected to undergo RFCA for ventricular ectopic beat originating in the right outflow tract.Their mean age was 45.1 years(15～67) with the mean course of 6.8 years(3～14).All of them were highly symptomatic,refractory to several antiarrhythmic agents and without evidences of structural heart disease.All ventricular ectopic beat had figure of left bundle branch block with tall R waves in leads Ⅱ,Ⅲ and AVF.The site of origin was determined by pace Mepping.Results The immediate success rate was 94%(49/52).Before and after ablation Holter monitoring found that ventricular ectopic beats were 11250～37460 beats/24h and 0～1120 beats/24h,respectively(P<0.001).During the follow-up period of 2～32 months,no patient had recurrences.Conclusions RFCA used in treating refractory ventricular ectopic beat at right outflow tract is safe and reliable.