单导管射频消融治疗右心室心律失常的疗效与安全性

目的 探讨单导管射频消融治疗右心室室性心律失常(RVA)的疗效与安全性.方法 回顾性分析2003年5月至2008年5月温州医学院附属第二医院心内科收治的111例患者资料,其中男41例、女70例,年龄(45.2±16.7)岁.其中右心室流出道(RVOT)室性心律失常104例[室性心动过速(VT)13例,室性早搏(PVC)91例],右心室流人道PVC 7例.根据是台采用单根消融导管技术,将患者分为两组:(1)单导管组:76例,男27例、女49例,年龄(44.5±16.9)岁;RVOT-PVC 62例,RVOT-VT9例,RVlT-PVC 5例.(2)常规组:35例,男14例,女21例,年龄(46.7±16.5)岁;ROOT-PVC 29例,RVOT-VT4例,RVIT-PVC 2例.结果 两组均顺利完成消融术,未发生严重并发症.单导管组手术操作时间和X线曝光时间[(55.23±26.24)min和(9.93±5.32)min]较常规组[(68.37±21.83)min和(12.96±4.54)min]短(t:2.76和3.09,均P<0.01),手术费用(12440.32±761.24)元较常规组(22119.51±1071.07)元节省(t:46.09,P<0.001);其近、远期成功率分别为93.42%(71/76)、97.18%(69/71)与94.29%(33/35)、96.97%(32/33),差异无统计学意义,两组其他符项参数差异无统计学意义(P>0.05).结论 单导管射频消融治疗RVA安全、有效,操作简化,节省费用.

The safety and clinical effects using single cathter ablation of arrhythmia originating from right ventricular

Objective To evaluate the safety and clinical effects of radiofrequency single catheter ablation (RESCA)for right ventrieular arrhythmia(RVA).Method A total of 111 patients data in the Second Affiliated Hospital of Wenzhou Medical College from May 2003 to May 2008,were retrospectively analyzed aged(45.2±16.7)years old including 41 men and 70 women,consisted of 13 patients of ventricular tachycardia(VT)and 98 patients of premature ventricular contractions(PVC).There were 104 casess from right ventricular outflow tract arrhythmia(RVOTA)and 7 cases from right ventricular inflow tract arrhythmia(RVITA).According to use single catheter approach or common technique,electrophysiolo-gical study,pacing and/or activation mapping and Catheter ablation were performed,were separated into two groups.①Single catheter group:27 men and 49 women,ages(44.5±16.9)years old;consisted of 62 patients of RVOT-PVC,9 patients of RVOT-VT and 5 patients of RVIT-PVC.②Control group:14 men and 21 women,ages(46.7±16.5)years old;consisted of 29 patients of RVOR-PVC,4 patients of RVOT-VT and 2 patients of RVIT-PVC.Results Operations in two groups came off smoothly and no ablation related complications in two groups.Procedure time and fluoroscopy time[(55.23±26.24)min and(9.93±5.32)min]in single catheter group were significantly shorter than those in control group [(68.37±21.83)min and(12.96±4.54)min,t=2.76 and 3.09,all P<0.01].Cost in the fromer (12440.32±761.24)RMB were significantly less than those in the latter[(22119.51±1071.07)RMB,t=46.09,P<0.01].Ablated successful rate in the near future,at a specified future date and other parameter were similar in two groups.Conclusions Right ventricular arrhythmia can be ablated with single catheter approach in safety,efficacious,easy to operate and lower cost.