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目的探讨射频消融治疗右室流出道室性早搏的方法和疗效。方法选择54例右室流出道室性早搏患者进行射频消融治疗,其中男21例,女33例,年龄(35.4±13.1)岁,既往无器质性心脏病史,所有患者曾应用2～3种抗心律失常药物治疗效果不佳。心电图显示室性早搏均呈左束支阻滞型,Ⅱ、Ⅲ、aVF导联QRS波呈高大R波。采用起搏标测和激动顺序标测结合的方法。结果即刻成功率90.74%(49/54)。成功患者术前与术后24h动态心电图检查室性早搏(19503.4±9797.2)次/24h和(20.3±34.9)次/24h,两者间差异明显(p<0.01)。随访1～26个月,平均6.9±6.8月,有7人复发,无严重并发症。结论无器质性心脏病的顽固性右室流出道室早的导管射频消融是一种安全可靠的方法。
Objective To investigate the method and effect of radiofrequency catheter ablation of ventricular premature beats in right ventricular outflow tract. Methods 54 patients with right ventricular outflow tract premature ventricular contractions were treated with radiofrequency ablation, including 21 males and 33 females, with a mean age of (35.4 ± 13.1) years. There was no previous history of organic heart disease. All patients had 2 to 3 Antiarrhythmic drugs are ineffective. ECG showed premature ventricular contractions were left bundle branch block, Ⅱ, Ⅲ, aVF lead QRS wave was tall R wave. Using pacing mapping and activation sequence mapping method. Results Immediate success rate was 90.74% (49/54). Preoperative and postoperative24h Holter ventricular premature beat (19503.4 ± 9797.2) times / 24h and (20.3 ± 34.9) times / 24h, the difference was significant (p <0.01). All cases were followed up for 1 ~ 26 months, with an average of 6.9 ± 6.8 months. There were 7 recurrences without serious complications. Conclusions Earlier catheter radiofrequency ablation of refractory right ventricular outflow tract ventricular disease without organic heart disease is a safe and reliable method.