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目的 评价射频消融术 (RFCA)治疗频发室性早搏的适应证、疗效与安全性。方法 2 0 0 0年10月～ 2 0 0 2年 12月共对 18例 (男 10例、女 8例 ,年龄 2 9± 12岁 )频发室性早搏患者接受RFCA治疗 ,其中13例为频发单型性室性早搏、5例为频发室性早搏伴短阵室性心动过速 ,经常规化验、X线胸片及心脏超声等检查未发现器质性心脏病的证据。常规放置心脏标测导管进行室早初步定位 ,然后用“大头”消融导管标测室早最早激动点作为靶点消融。并于术前及术后复查 2 4h动态心电图观察RFCA疗效。结果 18例频发室性早搏患者中 15例成功 ,占 83.3% ,成功患者中 2 4h室性早搏明显减少 ,由术前 2 4h的 (2 2 5 2 0± 9937)次减少为 (5 97± 12 0 )次。另 3例无效。成功患者中 1例为频发室性早搏伴短阵多形性室性心动过速 ,术后室性早搏消失 ,随访 1年未见室速发作。所有患者均未发生并发症。结论 RFCA治疗频发单形性室速安全有效 ,故对自觉症状较重、药物疗效不佳的患者可用RFCA进行治疗 ;对室性早搏伴短阵多形性室速患者 ,用RFCA治疗室性早搏后可防止室速再发
Objective To evaluate the indications, efficacy and safety of radiofrequency ablation (RFCA) in the treatment of frequent ventricular premature beats. METHODS: From October 2000 to December 2002, 18 patients (10 males, 8 females, and 29 ± 12 years of age) with RFCA were treated with RFCA, of which 13 Frequent ventricular premature beats, 5 cases of frequent ventricular premature beats with bradycardia bradycardia, routine tests, X-ray and echocardiography showed no evidence of organic heart disease. Conventional placement of cardiac mapping catheter for early positioning of the chamber early, and then use the “big head” ablation catheter early detection of the earliest point of activation as a target ablation. And observed 24h preoperative and postoperative ECG observation of RFCA curative effect. Results Of the 18 patients with frequent premature ventricular contractions, 15 cases were successful, accounting for 83.3%. The success rate of premature ventricular contractions in 24 h was significantly decreased from (22 52 ± 99 37) to (5 97 ± 12 0) times. The other three cases are invalid. 1 case of successful patients with frequent ventricular premature beats with short-pleated polymorphic ventricular tachycardia, postoperative ventricular premature beats disappeared, 1-year follow-up no VT onset. No complications occurred in all patients. Conclusion RFCA treatment of frequent, monomorphic VT is safe and effective, so patients with severe symptoms and ineffective drug therapy can be treated with RFCA. For premature ventricular premature beats with short pleated VT, RFCA is used to treat ventricular Premature ventricular tachycardia to prevent recurrence