摘要
目的 :探讨起搏标测在心室内消融靶点定位中的价值 .方法 :36例患者 ,男 2 0例 ,女 16例 ,年龄 15～ 5 8岁 ,均无器质性心脏病背景 . 12例室早图形为CLBBB ,5例为CRBBB ,14例室速CLBBB ,5例室速为CRBBB .起搏标测寻找起搏与自发QRS波群形态的细微差异 ,依次逐区微调大头电极在心室内面的位置 ,直至起搏 12导联QRS波与自发QRS波形态完全一致则为靶点 ;激动标测就是反复调整“大头”尖端在心内膜位置 ,使心腔内室早波群比体表心电图QRS波起点提前程度最大或至少 10ms以上为消融靶点 .结果 :12例右室室早起搏标测与体表心电图粗标符合 ,5例左室室早中 3例精标与体表心电图粗标完全吻合 ,2例稍有出入 ,起搏标测的总符合率 97% ,激动标测的总符合率难于计算 ,14例手术成功的室早患者无复发 ,16例达消融终点的室速患者 ,2例分别在术后 6月和 8月复发并接受第二次射频手术 ,1例成功 ,总的即时成功率83 3% ,总的远期成功率 80 6 % .结论
Objective: To discuss the value of target site of radiofrequency catheter ablation in ventricular by pacing mapping. Methods: Target site of radiofrequency catheter ablation in ventricular by pacing mapping was performed in 36 cases. Male in 20, female in 16, age 15～58. All cases were not background of organic cardiac disease. Premature ventricular CLBBB in 12, CRBBB 5, ventricular tachycardia CLBBB and CRBBB were 14 and 5 respectively. Mapping was performed in endocardium of ventricular step by step by ablated catheter after puncture of femoral vein of artery. The earliest sites of premature ventricular were exactly mapped by excitation mapping under the guiding of 12-lead ECG and/or finding premature ventricular site by comparing 12-lead ECG in pacing with 12-lead in auto premature ventricular. Results: QRS wave of premature ventricular by pacing mapping in right ventricular accorded with 12-lead ECG in 12 cases, so did 3 among 5 cases in left ventricular. Successful rate was 97%. Ventricular tachycardia in 16 was disappeared except for 2 cases. Successful rate was 80 6% at a specified future date. Conclusion: Pacing mapping can provide accurate target site of radiofrequency catheter ablation in ventricular.
出处
《昆明医学院学报》
2003年第1期32-35,共4页
Journal of Kunming Medical College
关键词
起搏标测
激动标测
射频消融
Activation mapping
Pacing mapping
Radiofrequency catheter ablation
