中国心脏起搏与心电生理杂志
中國心髒起搏與心電生理雜誌
중국심장기박여심전생리잡지
CHINESE JOURNAL OF CARDIAC PACING AND ELECOPHYSIOLOGY
2001年
1期
11-13
,共3页
马长生%王建安%董建增%刘旭%周玉杰%王勇%颜红兵%赵瑞革%杜昕%刘兴鹏
馬長生%王建安%董建增%劉旭%週玉傑%王勇%顏紅兵%趙瑞革%杜昕%劉興鵬
마장생%왕건안%동건증%류욱%주옥걸%왕용%안홍병%조서혁%두흔%류흥붕
室性早搏%心室流出道%导管消融,射频电流%心电图
室性早搏%心室流齣道%導管消融,射頻電流%心電圖
실성조박%심실류출도%도관소융,사빈전류%심전도
评价单形室性早搏(简称室早)经导管射频消融治疗的有效性和安全 性。对97例症状严重的正常心脏室早患者进行了导管射频消融，男38例、女59例，年龄46.2 ±7.1岁。采用起搏标测和激动顺序标测，前者以起搏时与室早QRS波形态完全相同点为消融 靶点，后者以早搏时最早心室激动点为消融靶点。97例室早全部起源于心室流出道，右室流 出道室早95例，全部呈左束支阻滞形态；左室流出道室早2例，QRS波均呈右束支阻滞形态， 其中1例V1导联呈Rs形态，1 例呈rsr′形态。消融即刻成功率95.9%（93/97），24 h动态 心电图记录消融前后室早数为20 416±1 891次/24 h和122±140次/24 h(n=19,P<0 . 001)。所有病人无任何并发症。随访19±6月未服用任何抗心律失常药物的症状消除率为91% ，复发率是 4.3%（4/93），随访期间亦无不良反应和并发症发生。结论：经导管射频消融 可有效而安全地消除正常心脏单形室早，可作为症状严重、药物治疗无效或不能耐受患者的治疗选择。
評價單形室性早搏(簡稱室早)經導管射頻消融治療的有效性和安全 性。對97例癥狀嚴重的正常心髒室早患者進行瞭導管射頻消融，男38例、女59例，年齡46.2 ±7.1歲。採用起搏標測和激動順序標測，前者以起搏時與室早QRS波形態完全相同點為消融 靶點，後者以早搏時最早心室激動點為消融靶點。97例室早全部起源于心室流齣道，右室流 齣道室早95例，全部呈左束支阻滯形態；左室流齣道室早2例，QRS波均呈右束支阻滯形態， 其中1例V1導聯呈Rs形態，1 例呈rsr′形態。消融即刻成功率95.9%（93/97），24 h動態 心電圖記錄消融前後室早數為20 416±1 891次/24 h和122±140次/24 h(n=19,P<0 . 001)。所有病人無任何併髮癥。隨訪19±6月未服用任何抗心律失常藥物的癥狀消除率為91% ，複髮率是 4.3%（4/93），隨訪期間亦無不良反應和併髮癥髮生。結論：經導管射頻消融 可有效而安全地消除正常心髒單形室早，可作為癥狀嚴重、藥物治療無效或不能耐受患者的治療選擇。
평개단형실성조박(간칭실조)경도관사빈소융치료적유효성화안전 성。대97례증상엄중적정상심장실조환자진행료도관사빈소융，남38례、녀59례，년령46.2 ±7.1세。채용기박표측화격동순서표측，전자이기박시여실조QRS파형태완전상동점위소융 파점，후자이조박시최조심실격동점위소융파점。97례실조전부기원우심실류출도，우실류 출도실조95례，전부정좌속지조체형태；좌실류출도실조2례，QRS파균정우속지조체형태， 기중1례V1도련정Rs형태，1 례정rsr′형태。소융즉각성공솔95.9%（93/97），24 h동태 심전도기록소융전후실조수위20 416±1 891차/24 h화122±140차/24 h(n=19,P<0 . 001)。소유병인무임하병발증。수방19±6월미복용임하항심률실상약물적증상소제솔위91% ，복발솔시 4.3%（4/93），수방기간역무불량반응화병발증발생。결론：경도관사빈소융 가유효이안전지소제정상심장단형실조，가작위증상엄중、약물치료무효혹불능내수환자적치료선택。
To evaluate the feasibility and safety of radiofrequency catheter ablati on for eradication of symptomatic monomorphic ventricular ectopic beats.This st udy included 97 patients (M/F 38/59,mean age 46.2±7.1 years;right ventricular outflow tract oringin in 95 patients and left ventricular outflow tract oringin in 2 patients ) with severely symptomatic frequent ventricular ectopic beats (me an frequency 20416±1891/24 hours).The site of origin was determined by activati on mapping for the earliest endocardial activation,and/or by pace mapping for the exact QRS match between pacing and ectopic beat.Radiofrequency catheter ablatio n successed in 95.9%(93/97) patients with a mean frequency of ventricular ectopic beats of 122±140/24hours after the ablation，P<0.001.No complication s encountered.During a mean follow-up period of 19±6 months,the patient with successful ablation were not given any antiarrhythmic drugs and were symptom-free in most of them (91.4%) .Recurrence occurred in 4 patients in the 93 succ essful cases,and there were no late complications.Conclusion:Radiofrequency cat heter ablation is an effective and safe treatment for frequent monomorphic ventr icular ectopic beats.It may therefore be a reasonable alternative for the treatm ent of severely symptomatic,drug-resistant or intolerable monomorphic ventricul ar ectopic activities in patients without significant structural heart disease.
