摘要
总结导管射频消融 (RFCA)治疗 5例器质性心脏病室性心动过速 (简称室速 )的体会。电生理检查与RFCA一次完成。激动或 (和 )起搏标测确定靶点后消融。结果 :1例致心律失常性右室心肌病室速在右室心底部标测到较体表心电图 (ECG)之QRS波群提前 34ms的起始碎裂电位 ,室速可被隐匿拖带。 1例肥厚型心肌病术中发作 4种形态室速 ,分别于右室游离壁 ,流出道后侧壁、间隔前下及间隔前上标测到较体表ECG的QRS波群提前 40ms以上的碎裂电位 ,分别以此为靶点消融成功。 1例陈旧性心肌梗死室速于左室游离壁标测到较体表QRS波群提前 46ms的局部碎裂电位 ,起搏标测 12导联QRS波群形态与室速时完全一致 ,以此靶点消融成功。 1例扩张型心肌病 ,诱发束支折返性室速 ,消融右束支。 4例均消融成功 ,随访 10个月至 7年无复发。 1例Fallot四联征矫正术后患者有右室流出道室速发作 ,术中未能诱发室速 ,在起搏标测下消融 ,1个月后复发。 5例患者共发作 10种形态室速 ,消融成功 9种 ,复发 1种。平均手术时间 144min ,X线曝光时间 6 5min。结论 :对器质性心脏病反复发作的持续性单形性室速 。
To summarize the experience on the treatment of pathologic ventricular tachycardia (VT) by radiofrequency catheter ablation (RFCA).Electrophysiologic study (EPS) and RFCA were performed in one session.The target site was found through activation mapping and/or pacemapping.Results:In one case of arrhythmogenic right ventricular cardiomyopathy and one case of hypertrophyic cardiomyopathy,five VTs were ablated at bottom,free wall and outflow tract of right ventricle.In one case of myocardia infarction,VT was ablated at the free wall of left ventricle.In one case of dilated cardiomyopathy,VT could not be induced after right branch bundle had been ablated.No VT recurred in all the above four cases during followup from 10 months to 7 years.In one case of tetralogy of Fallot,VT could not be induced in EPS,the target site was found by pacemapping only at right ventricular outflow.VT recurred one month after ablation.Altogether there were 10 kinds of VT episode,among which nine were successfully ablated,one recurred.Conclusion:RFCA is an effective method for sustained pathologic VT.[Chinese Journal of Cardiac Pacing and Electrophysiology,2000,14(2):82～84] Ventricular tachycardia Structural heart disease Catheter ablation,radiofrequency current
出处
《中国心脏起搏与心电生理杂志》
2000年第2期82-84,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
