窦性心律下异常电位消融治疗室性心律失常的远期预后
Long-term outcomes of ventricular arrhythmia treatment by abnormal potentials ablation under the sinus rhythm
目的 评价将心室局部异常电位(LAVPs)作为消融靶点治疗室性心律失常的远期预后.方法 入选2011年1月至2012年6月在阜外心血管病医院行室性心律失常射频消融治疗的器质性心脏病患者11例(男7例),年龄17~72(46.6±16.1)岁.在窦性心律下标测LAVPs,将消融后LAVPs的消失或电压的明显降低作为手术终点.研究终点是室性心动过速再发或全因死亡.结果 8例在术中标测到LAVPs(72.7%),7例患者消融术后LAVPs消失或降低,1例反复放电LAVPs无改变.初次消融术后平均随访14个月,5例患者室速复发(45.5%),无死亡病例.LAVPs消融有效的7例患者中1例复发,LAVPs消融无效的1例患者以及未标测到LAVPs的3例患者均于术后6个月内复发.结论 窦性心律下有效消融LAVPs可作为射频导管消融治疗器质性心脏病患者室性心律失常的终点.
更多Objective To evaluate the elimination of local abnormal ventricular potentials (LAVPs) during sinus rhythm would be a useful and effective end point for ventricular tachycardia (VT) ablation.Methods Eleven patients (age,17-72 years,7 male) with VT and structurally abnormal ventricle were enrolled from January 2011 to June 2012 in fuwai cardiovascular hospital.LAVPs were accepted targets in the VT ablation procedure.The study endpoints were VT reoccurrence or all-cause death.Results A high-density mapping catheter was used in the endocardium.LAVPs were recorded in 8 patients (72.7%).Catheter ablation was performed targeting LAVPs with catheter placed endocardially.LAVPs were successfully abolished or voltage reduced in 7 of 8 patients (87.5%).There were 5 patients (45.5%) VT recurred during long-term follow-up (median,14 months),of whom just one was in the group of LAVPs eliminated.Conclusion LAVPs can be identified in most patients with scar-related VT.Elimination of LAVPs is feasible and safe and is associated with superior survival free from recurrent VT.
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