摘要
目的 特发性室性心动过速是临床较少见的心律失常，目前相关的较大系列临床资料并不多见。兹对多年来我院接收射频消融治疗的病例进行总结。方法 共有１０９例患者（男性１３７例，女性 ５３例），平均年龄（３２．１±１３．３）岁。特发性左心室心动过速（ｉｄｉｏｐａｔｈｉｃ ｌｅｆｔ ｖｅｎｔｒｉｃｕｌａｒ ｔａｃｈｙｃａｒｄｉａ，ＩＬＶＴ）１１３例；发生于右心室流出道（ｒｉｇｈ ｖｅｎｔｒｉｃｕｌａｒ ｏｕｔｆｌｏｗ ｔｒａｃｔ，ＲＶＯＴ）者为７７例，其中 ３６．４％（２８／７７）为反复发作的单形室性心动过速（ｒｅｐｅｔｉｔｉｖｅ ｍｏｎｏｍｏｒｐｈｉｃ ｖｅｎｔｒｉｃｕｌａｒ ｔａｃｈｙｃａｒｄｉａ，ＲＭＶＴ）。所有患者均经药物治疗无效，在停服抗心律失常药物至少５个半衰期后进行心内电生理检查，在诱发出室性心动过速后进行射频消融治疗。术后平均随访（３１±１８）个月。结果ＩＬＶＴ患者平均年龄（３５．９±１２．８）岁而ＲＶＯＴ患者为（２９．５±１３．０）岁（Ｐ＜０．０５）。同时，ＩＬＶＴ患者中男性占８６．１％，而在ＲＶＯＴ患者中则只占５１．４％。只有８例ＩＬＶＴ患者被发现有左心室假健索，３例有二尖瓣脱垂，３例伴心动过速性心肌病。７７例?
Objective Idiopathic ventricular tachycardia (VT) is an uncommon clinical entity. The purpose of this study was to assess the results of catheter ablation therapy and the post-operative outcome of patients with idio- pathic VT in a relatively large series of patients. Method Electrophysiological study and an attempt of radiofre- quency catheter ablation were performed on 190 consecutive patients [male: 137,female:53;mean age(32.0±13.3) years]of our hospital from year 1992 through 2000. Results One hundred and thirteen patients had idiopathic left ventricular tachycardia (ILVT), seventy-seven patients had VT originated from the right ventricular outflow tract (RVOT), of which, 36.4% (28/77)with repetitive monomorphic ventricular tachycardia (RMVT) .The average age was(35.9±12.8)years and (29.5 ±13.O)years in patients with ILVT and RVOT VT, respectively.Meanwhile, 86.1% of patients were male in ILVT group and such percentage was only 51.4% in RVOT VT group.ln ILVT group, 105 VTs originated from mid-or inferior-left septum, 1 from left ventricular free wall, 4 from high left septum and 3 from infra left coronary sinus. The successful rate of ablation was 90.5% in WVI group. In RVOT VT group, activation mapping combined pace mapping was applied, the successful rate of ablation was 89.7% . In patients with RVOT VT, there were 28.6% of patients had 11 leads and 71.4% had 12 leads QRS morphology identical with that of spontaneous RV(ff VT. Eighteen patients (9.5%)reported recurrence during (31±18)months follow-up period and successful reablation was achieved in 8 patients. Conchdon Radiofrequency ablation is a successful procedure to treat idiopathic ventricular tachycardia.
出处
《中华心律失常学杂志》
2001年第6期328-332,共5页
Chinese Journal of Cardiac Arrhythmias
