CAJ | 학술논문

目的经主动脉逆行法是消融左心室起源室性心律失常的常规路径,但部分患者因合并禁忌证而无法应用或应用此法时导管难以到位.本研究旨在观察通过穿刺房间隔途径消融左心室起源室性心律失常的安全性和有效性.方法自2011年10月至2013年12月在阜外心血管病医院共入选13例合并主动脉逆行法禁忌证或既往经主动脉逆行法消融失败的左心室起源室性心律失常患者,应用Agilis鞘穿刺房间隔实施导管消融术并随访.结果 13例患者,其中5例室性早搏(室早),8例室性心动过速(室速).2例为左后分支起源的室速,1例为左前分支起源的室速,其余均为游离壁起源.术中均达到消融终点,无并发症发生.中位手术时间53 (40～ 72) min,X线曝光时间20(9～25) min.随访至术后4(1～23)个月,1例室速患者复发,再次经房间隔穿刺途径消融成功,另12例患者均无复发.结论应用Agilis鞘穿刺房间隔消融左心室起源的室性心律失常安全有效,是主动脉逆行法的重要补充.
목적 경주동맥역행법시소융좌심실기원실성심률실상적상규로경,단부분환자인합병금기증이무법응용혹응용차법시도관난이도위.본연구지재관찰통과천자방간격도경소융좌심실기원실성심률실상적안전성화유효성.방법 자2011년10월지2013년12월재부외심혈관병의원공입선13례합병주동맥역행법금기증혹기왕경주동맥역행법소융실패적좌심실기원실성심률실상환자,응용Agilis초천자방간격실시도관소융술병수방.결과 13례환자,기중5례실성조박(실조),8례실성심동과속(실속).2례위좌후분지기원적실속,1례위좌전분지기원적실속,기여균위유리벽기원.술중균체도소융종점,무병발증발생.중위수술시간53 (40～ 72) min,X선폭광시간20(9～25) min.수방지술후4(1～23)개월,1례실속환자복발,재차경방간격천자도경소융성공,령12례환자균무복발.결론 응용Agilis초천자방간격소융좌심실기원적실성심률실상안전유효,시주동맥역행법적중요보충.
Objective Catheter ablation of ventricular arrhythmias originating from left ventricle is usually performed via retrograde-transaortic approach,which is limited in some cases.The experience of transseptal approach for left ventricular arrhythmias ablation has not been reported in China.Methods Thirteen patients with left ventricular arrhythmias who had contraindications or failed to ablation via retrograde-transaortic approach were enrolled.Catheter ablation was performed via transseptal approach with an agilis sheath in all cases.Results All ablation procedures succeeded without any complication.The median total procedural and fluoroscopy times were 53 (40-72) minutes and 20 (9-25) minutes.During a median follow-up period of 4 (1-23) months,recurrence was only observed in 1 case with ventricular tachycardia which was cured by repeat ablation via transseptal approach.Conclusion Transseptal approach is safe and effective for left ventricular arrhythmia catheter ablation.