CAJ | 학술논문

　　目的探讨右心室流出道（RVOT）室性心律失常局部电压电位（LVPs）在标测过程中的意义。方法回顾分析47例RVOT起源室性心律失常标测消融靶点时LVPs出现率以及在窦性心律、室性心律失常时LVPs与V波的位置关系。结果47例均消融成功，平均消融（8±6）次。有效消融靶点与无效消融靶点局部心室激动时间分别为（-28±8）ms和（-24±7）ms，两者差异有统计学意义（P＜0.05）。有效靶点腔内图发现LVPs 47次（81.0%），无效靶点腔内图发现LVPs 22次（6.9%），两者差异有显著统计学意义（P＜0.01）。复发2例，复发者在第1次消融时靶点部位腔内图均未见LVPs，再次消融时成功靶点均标测到LVPs。LVPs判别有效消融靶点的阳性预测值为68.4%，阴性预测值为93.1%。结论在RVOT起源的室性心律失常中，LVPs可能是成功消融靶点的特征之一，标测LVPs有利于提高RVOT起源室性心律失常消融的成功率。
　　목적탐토우심실류출도（RVOT）실성심률실상국부전압전위（LVPs）재표측과정중적의의。방법회고분석47례RVOT기원실성심률실상표측소융파점시LVPs출현솔이급재두성심률、실성심률실상시LVPs여V파적위치관계。결과47례균소융성공，평균소융（8±6）차。유효소융파점여무효소융파점국부심실격동시간분별위（-28±8）ms화（-24±7）ms，량자차이유통계학의의（P＜0.05）。유효파점강내도발현LVPs 47차（81.0%），무효파점강내도발현LVPs 22차（6.9%），량자차이유현저통계학의의（P＜0.01）。복발2례，복발자재제1차소융시파점부위강내도균미견LVPs，재차소융시성공파점균표측도LVPs。LVPs판별유효소융파점적양성예측치위68.4%，음성예측치위93.1%。결론재RVOT기원적실성심률실상중，LVPs가능시성공소융파점적특정지일，표측LVPs유리우제고RVOT기원실성심률실상소융적성공솔。
Objective To investigate the role of local voltage potentials (LVPs) in mapping the originating site of right ventricular outflow tract (RVOT) arrhythmia. Methods The occurrence rate of LVPs during mapping of RVOT arrhythmia, and the relative position of LVP to V potential during sinus rhythm and ventricular arrhythmia were retrospectively analyzed in 47 cases. Results Radiofrequency ablation was successful in all cases. Catheter ablation was performed at a mean of 8±6 sites per patient. LVPs were slightly earlier at effective ablation sites than at ineffective sites (- 28±8ms vs- 24± 7ms, P<0.05). The LVPs were recorded in 47 of 58 effective ablation sites (81.0%), but only in 22 of 318 ineffective sites (6.9%)(P<0.05). Ventricular arrhythmia reoccurred in two cases with no LVP in intracardiac electrogram during first abla-tion. LVP was recorded during repeat ablation. The positive and negative predictive values of LVP in discriminating effec-tive ablation sites were 68.4%and 93.1%, respectively. Conclusion LVPs may be one of features of successful ablation sites of RVOT arrhythmia and mapping of LVPs may improve success rate of ablation.