CAJ | 학술논문

目的：探讨CARTO3指导下室性早搏射频消融的方法和成功率。方法61例室性早搏患者根据体表心电图及动态心电图初步确定起源部位， CARTO3指导下激动标测，最早激动点且局部单极电图呈QS为靶点；温控消融，功率20~50W。结果室性早搏右心室流出道起源33例，消融成功率90.9%，间隔部起源成功率93.1%；起源于房室瓣环7例，消融成功率85.7%；非左室流出道起源消融成功患者V2导联最早心室激动至R波峰间期（Intrinsicoid deflection time，IDT）显著短于消融失败患者（34.2±8.4 ms vs.51.6±17.9 ms, P＜0.01）。结论CARTO3指导下射频消融起源于心室流出道、房室瓣环等部位的室性早搏安全有效，以右室流出道间隔部成功率最高，IDT值对于术前估测消融成功率有指导作用。
목적：탐토CARTO3지도하실성조박사빈소융적방법화성공솔。방법61례실성조박환자근거체표심전도급동태심전도초보학정기원부위， CARTO3지도하격동표측，최조격동점차국부단겁전도정QS위파점；온공소융，공솔20~50W。결과실성조박우심실류출도기원33례，소융성공솔90.9%，간격부기원성공솔93.1%；기원우방실판배7례，소융성공솔85.7%；비좌실류출도기원소융성공환자V2도련최조심실격동지R파봉간기（Intrinsicoid deflection time，IDT）현저단우소융실패환자（34.2±8.4 ms vs.51.6±17.9 ms, P＜0.01）。결론CARTO3지도하사빈소융기원우심실류출도、방실판배등부위적실성조박안전유효，이우실류출도간격부성공솔최고，IDT치대우술전고측소융성공솔유지도작용。
Objective To discuss the approaches and success rate of radiofrequency ablation for ventricular premature beat (VPB) guided by CARTO3 system. Methods The original sites of VPB were initially decided according to surface electrocardiogram and ambulatory electrocardiogram in 61 patients. The activation mapping was carried out guided by CARTO3 taken the earliest activation points and QS showed in local unipolar electrocardiogram as targets. Temperature controlled radiofrequency catheter was used, and the powder was from 20 W to 50 W. Results VPB was derived from right ventricular outflow tract (RVOT) in 33 patients and success rate of radiofrequency ablation was 90.9%, and success rate was 93.1%in patients with VPB derived from RVOT septum. VPB was derived from atrioventricular annulus in 7 patients and success rate of radiofrequency ablation was 85.7%. Intrinsicoid deflection time (IDT) of the earliest ventricular activation in V2 lead to R inter-peak latency of surface electrocardiogram was significantly shorter in patients with non-left ventricular outflow tract and successful radiofrequency ablation than that in those with unsuccessful radiofrequency ablation (34.2±8.4 ms vs. 51.6±17.9 ms, P<0.01). Conclusion Radiofrequency ablation guided by CARTO3 is safe and effective in patients with VPB derived from ventricular outflow tract and atrioventricular annulus. The success rate is the highest in the patients with VPB derived from RVOT. IDT plays a guiding role in predicting the success rate of radiofrequency ablation before the operation.