射频消融治疗心室流出道特发性室性心律失常的临床评价

目的探讨射频消融治疗心室流出道特发性室性心动过速（VT）和室性早搏（PVC）的临床效果、心电图及电生理特征。方法采用起搏标测、激动标测和非接触标测的方法对105例心室流出道室性心律失常的患者进行射频消融治疗,其中男42例,女63例,年龄47±16（12—73）岁。VT27例,PVC78例。结果（1）105例患者中97例成功,8例失败,成功率93．3％。15例复发,复发者再次消融后成功。（2）起源于右室流出道84例,左室流出道21例。其中起源于主动脉瓣上Valsalva左冠窦16例,主动脉瓣下左室流出道心内膜2例,主动脉瓣与二尖瓣环纤维连接处3例。（3）术中出现1例急性心包压塞,2例少量心包积液。结论射频导管消融治疗心室流出道特发性室性心律失常是一种安全、有效的方法。

Clinical evaluation of catheter ablation for idiopathic ventricular arrhythmia originating from ventricular outflow tract

OBJECTIVE: To study the ECG and electrophysiological characteristic of idiopathic ventricular tachycardia (VT) and premature ventricular contraction (PVC) originating from ventricular outflow tract and assess the clinical effect of radiofrequency catheter ablation (RFCA) for treatment. METHODS: 105 patients aged from 12 to 73 years old were treated with RFCA. Activation mapping, pace mapping and non-contact mapping system of Ensite 3000 were used during the procedure. RESULTS: (1) VT and PVC were successfully ablated in 97 out of the 105 patients (93.3%), 15 were recurrent but succeed in the second time. (2) 84 patients originated from right ventricle outflow tract (RVOT) and the remaining 21 patients from left ventricle outflow tract (LVOT). (3) 3 patients have the pericardial tamponade during ablation. CONCLUSION: RFCA is an effective and curative therapy for ventricular arrhythmia originating from ventricular outflow tract.