王岳松, 董学滨, 王学忠, 邵旭武, 方永华, 鄂丽丽. 非接触球囊标测系统指导下右室流出道室性期前收缩导管消融疗效及体表心电图应用价值[J]. 心脏杂志, 2015, 27(3): 298-300.
    引用本文: 王岳松, 董学滨, 王学忠, 邵旭武, 方永华, 鄂丽丽. 非接触球囊标测系统指导下右室流出道室性期前收缩导管消融疗效及体表心电图应用价值[J]. 心脏杂志, 2015, 27(3): 298-300.
    Catheter ablation of premature ventricular contraction arising from right ventricular outflow tract with noncontact mapping and electrocardiogram useful value[J]. Chinese Heart Journal, 2015, 27(3): 298-300.
    Citation: Catheter ablation of premature ventricular contraction arising from right ventricular outflow tract with noncontact mapping and electrocardiogram useful value[J]. Chinese Heart Journal, 2015, 27(3): 298-300.

    非接触球囊标测系统指导下右室流出道室性期前收缩导管消融疗效及体表心电图应用价值

    Catheter ablation of premature ventricular contraction arising from right ventricular outflow tract with noncontact mapping and electrocardiogram useful value

    • 摘要: 目的:探讨非接触球囊标测系统指导下右室流出道室性期前收缩(室早)导管消融疗效及体表心电图应用价值。方法:术前根据同步12导联体表心电图室早的形态特征初步判断室早起源部位,对58例药物治疗无效的顽固性室早患者进行导管射频消融治疗,其中26例采用传统标测法,32例采用非接触球囊标测法(Ensite三维标测法)。结果:①非接触球囊标测法与传统标测法相比较,成功率高(100% vs. 81%)、复发率低(3% vs. 19%),X线曝光时间短[(3.6±1.4)min vs.(32±12)min];②标测和消融结果显示30例患者室早起源于右室流出道间隔部,其中7例起源于前间隔,9例起源于中间隔,14例起源于后间隔。22例患者室早起源于右室流出道游离壁,其中7例起源于前游离壁,4例起源于中游离壁,11例起源于后游离壁。体表心电图特征对判断室早起源部位具有较高的灵敏度、特异度和准确度。结论:非接触球囊标测系统指导右室流出道室性心律失常射频消融安全有效,仔细分析心电图室早QRS波形态特征有助于判定室早起源部位,并缩短手术时间。

       

      Abstract: AIM:To assess the clinical value of noncontact mapping (NCM) system in guiding radiofrequency ablation of premature ventricular contraction (PVC) arising from right ventricular outflow tract and the electrocardiogram characteristics. METHODS: A total of 58 PVC patients received radiofrequency catheter ablation (RFCA) and the origin of PVC was inferred from 12-lead surface electrocardiogram before RFCA. Conventional mapping (CM) was performed in 26 patients and guidance of noncontact mapping in 32 patients. RESULTS: Success rate with NCM was higher, recurrence rate was lower and X ray exposure time was shorter than those with CM [100% vs. 81%; 3% vs. 19%; (3.6±1.4) min vs.(32±12) min, respectively]. Successful ablation was achieved at sites of RVOT septum in 30 patients (seven from the anterior septum, nine from the midregion septum, 14 from the posterior septum). Successful ablation was achieved at sites of RVOT freewall in 22 patients (seven from the anterior wall, four from the mid-wall, and 11 from the posterior wall). Sensitivity, specificity and accuracy of electrocardiogram for predicting PVC sites were high. CONCLUSION: Noncontact mapping system is useful for effective ablation of PVC originating from RVOT. Careful analysis of electrocardiogram characteristics is helpful in shortening the time of ablation.

       

    /

    返回文章
    返回