特发性室性心动过速非药物治疗方法临床探究.docVIP

特发性室性心动过速非药物治疗方法临床探究 　 作者：陈聪 梁岩 徐国帆 杨平珍 叶海鹏 张凌宇 陈杰山 邱伟兰 蒋学军 陆宇 【关键词】 心动 　　摘要：目的：通过对13例特发性室性心动过速(IVT)的射频消融病例的疗效观察，探索射频消融术（RFCA）作为非药物性治疗方法治疗IVT的可行性、安全性和有效性。方法：13例IVT患者中男性9例，女性4例，术前停用任何抗心律失常药5个半衰期以上。采用心内激动顺序标测及起搏标测两种方法相结合来确定消融靶点。射频消融均采用温度控制方式进行，温度上限为60℃，功率上限为50W。成功标准为消融过程中心动过速终止且不能再诱发。结果:13例患者中12例诱发出心动过速者均消融成功，总成功率为92.3%。其中5例右室特发性室速中4例消融靶点位于流出道间隔部，1例位于流出道游离侧；7例左室特发性室速中5例消融靶点于左心室间隔中下部，1例左心室流出道，1例近心尖部未能稳定诱发心动过速，术后不能诱发，但随访二月时再发室性心动过速，再次行消融取得成功。成功病例中术后未使用任何抗心律失常药，随访半年未见再发室性心动过速。另外1例电生理检查未诱发出心动过速者经采用起搏标测，仅10导联相吻合试行消融，术后一个月再发室性心动过速。所有病例术中未出现心包填塞、房室传导阻滞等手术相关性严重并发症。结论:射频消融术治疗IVT成功率高、安全性高，可以作为IVT非药物治疗的首选治疗手段。 　　关键词：室性心动过速；特发性；射频消融术 　　Clinical Study of Nonpharmacologic Treatment Ways For Patients with Idiopathic Ventricular Tachycardia 　　Abstract：Objective： Through Radiofrequency of tachycardia (IVT) melt curative effect of the case observe to 13 getting idiopathic room, it is analysed that the treatment means of RFCA and treats the feasibility, efficacy and safety of IVT, probes what treated IVT is not the medicine method . Method： Thirteen patients with IVT (including 9 males and 4 females). Stop using any to resist the above of 5 half- lives of medicine of arrhythmia cordis before the skill .Adopt heart excited order mark and examine, get up and fight, and then mark and examine two method combine together then confirm and melt target order. Radiofrequency melt adopt temperature control method go on, temperature upper limit 60℃, power upper limit 50 W. Succeed standard for melt course in the center move and stop and can bring out again rapidly. Result： Twelve brought out person who publishes tachycardia and melted and succeeded of 13 patients finally, total success rate was 92.3%. Among them 5 right room getting idiopathic room speed 4 melt target ordered and lie to flow out an alternate department, one lie and flow out dish and dissociate the side; 7 left room getting idiopathic room speed 5 melt some target on left ventricle underpart of the interval, 1 left ventricle flow o