中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2013年
3期
233-238
,共6页
孙育民%余金波%陈明龙%杨兵%张凤祥%沈法荣%王志军%居维竹%陈红武
孫育民%餘金波%陳明龍%楊兵%張鳳祥%瀋法榮%王誌軍%居維竹%陳紅武
손육민%여금파%진명룡%양병%장봉상%침법영%왕지군%거유죽%진홍무
导管消融术%除颤器,置入型%心动过速,室性
導管消融術%除顫器,置入型%心動過速,室性
도관소융술%제전기,치입형%심동과속,실성
Catheter ablation%Defibrillators,implantable%Tachycardia,ventricular
目的 分析导管射频消融治疗置人型心律转复除颤器(ICD)术后室性心律失常风暴(VAS)的即刻及远期疗效.方法 选择11例ICD术后发生VAS患者,回顾性分析行导管射频消融治疗的即刻及远期随访疗效.结果 11例共接受15次消融,其中心外膜途径6次.术中9例共诱发20种室性心动过速(室速),平均周长为(384±141)ms,20％为血液动力学不稳定性室速.7例诱发出多形性室速.平均X线透视时间(26±17) min,手术时间(189±60) min.即刻完全成功、部分成功及失败率分别为46.7％ (7/15)、26.7％ (4/15)和26.7％ (4/15).末次射频消融后平均随访(12.5±9.6)个月,无1例发生心脏性猝死或心因性死亡,导管消融的远期完全成功、部分成功及失败率分别为72.7％(8/11)、9.1％ (1/11)及18.2％ (2/11),总有效率为81.8％(9/11).结论 在大多数ICD术后VAS患者中,导管射频消融可通过成功抑制临床型室速而有效地控制VAS发作.
目的 分析導管射頻消融治療置人型心律轉複除顫器(ICD)術後室性心律失常風暴(VAS)的即刻及遠期療效.方法 選擇11例ICD術後髮生VAS患者,迴顧性分析行導管射頻消融治療的即刻及遠期隨訪療效.結果 11例共接受15次消融,其中心外膜途徑6次.術中9例共誘髮20種室性心動過速(室速),平均週長為(384±141)ms,20％為血液動力學不穩定性室速.7例誘髮齣多形性室速.平均X線透視時間(26±17) min,手術時間(189±60) min.即刻完全成功、部分成功及失敗率分彆為46.7％ (7/15)、26.7％ (4/15)和26.7％ (4/15).末次射頻消融後平均隨訪(12.5±9.6)箇月,無1例髮生心髒性猝死或心因性死亡,導管消融的遠期完全成功、部分成功及失敗率分彆為72.7％(8/11)、9.1％ (1/11)及18.2％ (2/11),總有效率為81.8％(9/11).結論 在大多數ICD術後VAS患者中,導管射頻消融可通過成功抑製臨床型室速而有效地控製VAS髮作.
목적 분석도관사빈소융치료치인형심률전복제전기(ICD)술후실성심률실상풍폭(VAS)적즉각급원기료효.방법 선택11례ICD술후발생VAS환자,회고성분석행도관사빈소융치료적즉각급원기수방료효.결과 11례공접수15차소융,기중심외막도경6차.술중9례공유발20충실성심동과속(실속),평균주장위(384±141)ms,20％위혈액동역학불은정성실속.7례유발출다형성실속.평균X선투시시간(26±17) min,수술시간(189±60) min.즉각완전성공、부분성공급실패솔분별위46.7％ (7/15)、26.7％ (4/15)화26.7％ (4/15).말차사빈소융후평균수방(12.5±9.6)개월,무1례발생심장성졸사혹심인성사망,도관소융적원기완전성공、부분성공급실패솔분별위72.7％(8/11)、9.1％ (1/11)급18.2％ (2/11),총유효솔위81.8％(9/11).결론 재대다수ICD술후VAS환자중,도관사빈소융가통과성공억제림상형실속이유효지공제VAS발작.
Objective To evaluate the acute and long-term effects of catheter radiofrequency ablation for the treatment of ventricular arrhythmia storm (VAS) post implantable cardioverter-defibrillators (ICD) implantation.Methods Acute and long-term effects of catheter radiofrequency ablation for the treatment of VAS post ICD implantation were retrospectively assessed in 11 patients from September 2008 to August 2011.Results A total of 15 ablation procedures were performed in 11 patients.Six ablation procedures were performed through epicardial approach.In 9 patients,20 types of ventricular tachycardia (VT) (including 20％ hemodynamically unstable VT) were induced during the procedures [mean cycle length (384 ± 141)ms] and polymorphic ventricular tachycardia were induced in 7 patients.The average Xray fluoroscopy time and procedural time were (26 ± 17) min and (189 ± 60) min,respectively.Complete success,partial success,and failure rates immediately post catheter radiofrequency ablation were 46.7％ (7/15),26.7％ (4/15) and 26.7 ％ (4/15),respectively.All patients are alive at follow-up [(2.45 ± 9.6)months after the last catheter ablation] and the complete success,partial success,and failure rates during follow-up were 72.7％ (8/11),9.1％ (1/11) and 18.2％ (2/11),respectively.Conclusion VAS can be effectively treated by catheter radiofrequency ablation in patients post ICD implantation.
