单形性室性早搏的射频导管消融术(摘要)
作者：马长生 王建安 刘旭 张晓
单位：北京市，中日友好医院 心内科(100029)
关键词：
目的 目的：本文报告了80例频发单形性室性早搏患者射频导管消融术的疗效和安全性。
方法：患者适应症如下①药物治疗难以控制的单形顽固性室性早搏；②患者具有严重的临床症状，心悸、气短、乏力及体力活动下降；③患者强烈要求行射频导管消融术。
结果：80例患者中男性53例，女性27例。年龄28～67岁，平均47岁。均无器质性心脏病证据，窦性心律体表心电图正常。其中，右心室流出道室性早搏79例，肺动脉瓣下间隔面部位占74例，肺动脉瓣下前游离壁部位占5例，呈完全左束支传导阻滞图形1例。室性早搏平均20 376±1 834次/24小时。操作时间85±25分，平均X线投射时间11.6±5.3分;80例患者77例即刻射频导管消融获得成功，3例失败，成功率96.25%，随访10～22个月无并发症发生。3例在射频导管消融术2～8周后复发，复发率3.89%。消融后室性早搏平均243±136次/24小时(P<0.001)。消融成功患者临床症状均有改善。
结论：起源于右心室流出道的单形性室性早搏可行射频导管消融治疗。其中以起源于右心室流出道的单形性室性早搏安全可靠、效果良好。
Radiofrequency Ablation of Monomorphic Ventricular Premature Beats (Abstract)
Department of Cardiology, China-Japan Friendship Hospital, Beijing (100029)
Ma Changsheng, Wang Jian′an, Liu Xu, et al.
Objective: To report the feasibility and safety of radiofrequency ablation (RA) of frequent monomorphic ventricular premature beats.
Methods: Eighty patients, 53 men and 27 women, age 28～67 (mean 47) years had normal rest ECGs without evidence of organic heart diseases. Ventricular premature beats were all of right ventricular outflow tract origin. Indications for RA included: ① drug refractory ventricular premature beats; ② patients with severe clinical symptoms; ③ patients strongly asking for radiofrequency ablation.
Results: Mean duration of the procedure was 85±12 min and mean fluroscopy time 11.6±5.3 min. 77 of the 80 cases had immediate success with success rate of 96.25% and no complications in a follow-up of 10～22 months. 3 cases had recurrence after 2～8 weeks with recurrence rate of 3.89%. The average pre- and post-operation ventricular premature beats were 20 376±1 824 beats/24 hours and 243±136 beats/24 hours, respectively (p<0.001).
Conclusion: Patients with ventricular premature beats arising from right ventricular outflow tract can undergo rediofrequency ablation effectively and safely., 百拇医药
单位：北京市，中日友好医院 心内科(100029)
关键词：
目的 目的：本文报告了80例频发单形性室性早搏患者射频导管消融术的疗效和安全性。
方法：患者适应症如下①药物治疗难以控制的单形顽固性室性早搏；②患者具有严重的临床症状，心悸、气短、乏力及体力活动下降；③患者强烈要求行射频导管消融术。
结果：80例患者中男性53例，女性27例。年龄28～67岁，平均47岁。均无器质性心脏病证据，窦性心律体表心电图正常。其中，右心室流出道室性早搏79例，肺动脉瓣下间隔面部位占74例，肺动脉瓣下前游离壁部位占5例，呈完全左束支传导阻滞图形1例。室性早搏平均20 376±1 834次/24小时。操作时间85±25分，平均X线投射时间11.6±5.3分;80例患者77例即刻射频导管消融获得成功，3例失败，成功率96.25%，随访10～22个月无并发症发生。3例在射频导管消融术2～8周后复发，复发率3.89%。消融后室性早搏平均243±136次/24小时(P<0.001)。消融成功患者临床症状均有改善。
结论：起源于右心室流出道的单形性室性早搏可行射频导管消融治疗。其中以起源于右心室流出道的单形性室性早搏安全可靠、效果良好。
Radiofrequency Ablation of Monomorphic Ventricular Premature Beats (Abstract)
Department of Cardiology, China-Japan Friendship Hospital, Beijing (100029)
Ma Changsheng, Wang Jian′an, Liu Xu, et al.
Objective: To report the feasibility and safety of radiofrequency ablation (RA) of frequent monomorphic ventricular premature beats.
Methods: Eighty patients, 53 men and 27 women, age 28～67 (mean 47) years had normal rest ECGs without evidence of organic heart diseases. Ventricular premature beats were all of right ventricular outflow tract origin. Indications for RA included: ① drug refractory ventricular premature beats; ② patients with severe clinical symptoms; ③ patients strongly asking for radiofrequency ablation.
Results: Mean duration of the procedure was 85±12 min and mean fluroscopy time 11.6±5.3 min. 77 of the 80 cases had immediate success with success rate of 96.25% and no complications in a follow-up of 10～22 months. 3 cases had recurrence after 2～8 weeks with recurrence rate of 3.89%. The average pre- and post-operation ventricular premature beats were 20 376±1 824 beats/24 hours and 243±136 beats/24 hours, respectively (p<0.001).
Conclusion: Patients with ventricular premature beats arising from right ventricular outflow tract can undergo rediofrequency ablation effectively and safely., 百拇医药