CAJ | 학술논문

目的探讨不同起源特发性室性期前收缩（PVCs）和（或）室性心动过速（VT）的射频导管消融（下称消融）治疗疗效及安全性。方法828例PVCs/VT患者接受消融治疗，采用X线影像或三维标测系统进行标测，普通或冷盐水消融导管进行消融，分析不同标测与消融方法治疗不同起源PVCs/VT的优缺点。结果右心室起源580例（70.05%），左心室起源248例（29.95%），其中右心室流出道最常见（469例，占56.64%），其次为左心室间隔部、左心室流出道、邻近三尖瓣环。左、右心室起源分别消融成功率分别为87.50%和95.52%。心内膜起源者采用普通温控消融导管消融，经冠状窦的心外膜消融则需应用冷盐水灌注导管。结论特发性PVCs/VT消融治疗安全有效，右心室起源者成功率更高。
목적탐토불동기원특발성실성기전수축（PVCs）화（혹）실성심동과속（VT）적사빈도관소융（하칭소융）치료료효급안전성。방법828례PVCs/VT환자접수소융치료，채용X선영상혹삼유표측계통진행표측，보통혹랭염수소융도관진행소융，분석불동표측여소융방법치료불동기원PVCs/VT적우결점。결과우심실기원580례（70.05%），좌심실기원248례（29.95%），기중우심실류출도최상견（469례，점56.64%），기차위좌심실간격부、좌심실류출도、린근삼첨판배。좌、우심실기원분별소융성공솔분별위87.50%화95.52%。심내막기원자채용보통온공소융도관소융，경관상두적심외막소융칙수응용랭염수관주도관。결론특발성PVCs/VT소융치료안전유효，우심실기원자성공솔경고。
Objective To explore the efficacy and safety of catheter radiofrequency ablation (RF)for idiopathic premature ventricular contraction (PVC) and ventricular tachycardia (VT) from different origins. Methods RF was performed with a conventional catheter or an irrigated- tip catheter in 828 patients with PVC/VT under the guidance of X- ray image or three- dimensional mapping systems. The advantage and disadvantage of different mapping and ablation strategies for different PVC/VT were analyzed. Results 580 cases had PVC/VT originating from right ventricle (70.05%) and 248 from left ventricle (29.95%). Right ventricular outflow tract was the most common site (56.64%), fol owed by left ventricular septum, left ventricular outflow tract and tricuspid annulus. Success rate of ablation was 95.52% for right ventricular origin and 87.50% for left ventricular origin. Conventional catheter with temperature control was used in endocardial ablation, and irrigated- tip catheter was required in epicardial ablation via coronary sinus ostium. Conclusion RF is safety and efficacy for idiopathic PVC/VT with a higher success rate for those from right ventricle.