导管射频消融治疗严重症状性室性早搏的初步研究.pdfVIP

第 26 卷第 9 期 南京医科大学学报(自然科学版) 2006 年 9 月 ACTA UNIVERS町ATIS MEDICINAUS NANJING(Natural Science) .809. 导管射频消融治疗严重症状性室性早姆的初步研究 邹瑞秀，刘志平，蒋建光，纪元， (南京医科大学附属常州市第二人民医院心内科，江苏常州 213∞3) [摘 要] 目的:探索导管射频消融治疗严囊症状性案性早搏(室主严)伴或不伴寒早诱发的短阵蜜性心动过速(索速)的安全性、 效率和方法学。方法:18 例严重症状性窒早患者入选本研究，术前窒早数量平均(117 土 37)次血。术前根据同步 12 导联体表心 电阁初步推测寒性早搏产生部位，术中依据初步推测的宣单产生部位采用心室激动顺序标测法与起锦标测法进行案与王标测定 位，大头消融电极标测到蜜早最早激动点较体表心电图 QRS 波提前 25 ms 以上或消融电极起搏心电图 QRS 波图形与蜜早图 形 11112 以上一致时放电消融。结泉:18 例患者导管射频消融~p 时成功 16 例，术后窒早数(6 士 2) 次/h，较术前显著减少(P 0.05); 随访 12 个月， 18 例中 16 例消融成功，成功率 88.9%; 无严撤并发症发生。结论:导管射频消融治疗严蒙症状性蜜早伴或 不伴蜜早诱发的短阵窒速安全、有效，同步 12 导联体表心电图对窒早的定位有3重要的指导意义。 [关键诩] 窒性早搏;窒性心动过速;导管射频消融 [中图分类号] R654.2 [文献标识码] A [文章编号] 1∞7-4368(2ω6)09-0809-04 Radiofrequency catheter ablation În the treatment for severely symptomatic premature ventrÎcular contractÎons ZOU Rui-xiu , UU Zhi-ping , JIANG Jian-guang , JI Yuan (Department 01 cαrdiology ， the Second Hospital 01 Chω~gzhou Affiliωed to N]MU， Chan萨hou 213003 ,Chi阳) [AbstractJ Objec创刊: To explore the efficiency ,safety of radiofrequency catheter ablation(RFCA) methods in eliminating frequent premature ventricular contraction (PVCs)in severely symptomatic patients with or without PVCs-induced short runs of ventricular tachycardia. Methods: Eighteen patients with severely symptomatic PVCs were enrolled. 叽le mean frequency of PVCs was 117 :1: 371 h documented by Holter ECG before RFCA. The origin of PVCs was inferred from 1 二lead surface electrocardiogram (ECG) before RFCA , and the site of origin was mapped both by pace-mapping and activation-mapping before RFCA. 叽le ahlation síte was at least 25 ms earlier than that of the onset of 12.1ead ECG while activation-mapping ,or the site produced the same mophorlogy at least in 11 翩lead ECGωthat of PVCs while pace咽apping. R