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左室特发性室性心动过速常规方法消融困难的线性消融(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第3期
页码:
344-346
栏目:
临床研究
出版日期:
2011-05-12

文章信息/Info

Title:
Radiofrequency catheter linear ablation in idiopathic left ventricular tachycardia patients not amenable to standard mapping ablation strategies
作者:
冯金忠; 吴峰; 骆合德; 邱一华; 周巍; 俞峰
解放军第98医院心内科，浙江 湖州 313001
Author(s):
FENG Jin-zhong;  WU Feng;  LUO He-de;  QIU Yi-hua;  ZHOU Wei;  YU Feng
Department of Cardiology, PLA 98 Hospital, Huzhou 313000, Zhejiang, China
关键词:
心动过速; 室性; 左室; 特发性; 室间隔; 左; 蒲肯野氏纤维电位; 导管消融; 线性消融
Keywords:
idiopathic left ventricular tachycardia;  left ventricular septum;  Purkinje potentials;  radiofrequency catheter ablation;  linear ablation
分类号:
R541.71
DOI:
-
文献标识码:
A
摘要:
目的:探讨在常规方法消融困难的左室特发性室性心动过速（ILVT）患者中室间隔左室面线性消融的有效性。方法: 18例术中不能诱发持续性心动过速或发作时不能耐受患者，进行室间隔左室面心尖到心底部连线的前1/3～1/2区域，在窦性心律下首先标到蒲肯野氏纤维电位（PP），向下至室间隔与左室下壁交界、向上至前后间隔中线进行线性消融，术后门诊或电话随访。结果： 所有患者术后即刻均未能诱发出ILVT。随访3~35（23±13）个月，3例/18例（17%）复发，远期成功率达83%，无1例发生永久性的并发症。结论: 对于术中不能诱发持续性心动过速或发作时不能耐受的ILVT患者，室间隔左室面线性消融安全有效，可以作为补救性消融措施。
Abstract:
AIM:To investigate the efficacy of linear ablation in the left ventricular (LV) septum in patients with idiopathic left ventricular tachycardia (ILVT) who were not amenable to “traditional” mapping. METHODS: In 18 ILVT patients, non-inducible/nonsustained VT and those unable to tolerate VT, a linear lesion along the mid to inferior septum was placed perpendicular to the long axis of the ventricle, approximately midway to one-third from the base to the apex in the region where the Purkinje potentials (PP) were recorded during sinus rhythm. RESULTS: During a follow-up of 22.8±12.6 months (range: 3-35 months), there were three recurrences of tachycardia in the 18 patients (16.7%). Long-term achievement ratio was 83.3% with no permanent complications. CONCLUSIONS: Linear ablation in the septum of the LV as a substitute mapping strategy was effective and safe in ILVT patients, noninducible/nonsustained VT and those unable to tolerate VT.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2010-07-26.作者简介：冯金忠，副主任医师，硕士Email:fengjzh98@163.com
更新日期/Last Update: 2011-03-17