左/右心室起源频发室性期前收缩分布及射频消融手术特点
The distribution of frequent premature ventricular contractions originated from left/right ventricular and characteristics of radiofrequency ablation
目的 系统比较起源于右心室和左心室室性期前收缩(PVC)分布特点及其射频消融手术特点的差异.方法 纳入354例频发性PVC患者,右心室起源的患者(右心室组)280例,左心室起源的患者(左心室组)74例,比较两组间年龄、男性比例、消融功率、消融温度、放电时间、靶电位较QRS波提前时间、X线曝光时间、手术时间、手术成功率等的差异.结果 PVC主要起源于右心室(占79.1%),其中以右心室流出道(RVOT)最多(55.9%);起源于左心室较少(占20.9%);右心室组和左心室组相比:发病年龄较轻[(44.7±13.6)岁比(49.6±15.9)岁,P=0.017],男性比例低[35.4%(99例)比55.4%(41例),P=0.002],差异有统计学意义;靶电位领先QRS时间、手术时间、X线曝光时间和手术成功率右心室组比左心室组分别:(37.9±16.2)ms比(31.3±11.7)ms,P=0.008;(85.1±36.9)min比(100.8±45.5)min,P=0.017;(12.3±9.2)min比(15.90±10.8)min,P=0.028和96.4%比89.2%,P=0.012.结论 射频消融频发PVC手术成功率高,是一种安全有效的方法.与左心室起源频发PVC相比,右心室起源患者发病年龄较轻,女性多发;射频消融手术较容易,手术时间和X线曝光时间短,手术成功率高.
更多Objective The aim of this study was to investigate the differences on origin distribution and radiofrequency ablation characteristics between premature ventricular contractions (PVC) from left and right ventricular.Methods A total of 354 frequent PVC patients were enrolled.Two hundred and eighty patients were PVCs with right ventricular origin (group RV) and 74 patients with left ventricular origin (group LV).The age,gender,ablation power,temperature and duration,time of target potential before QRS onset,fluoroscopic time,procedure time and success rate were compared between the two groups.Results Majority PVCs (79.10%) were of right ventricular origin,in which the most common site was at right ventricular outflow tract (RVOT) (55.93%);whereas,only 20.90% were of left ventricular.There were significantly differences between group RV and group LV in age [(44.7 ± 13.6) yrs vs (49.6 ±15.9) yrs,P =0.017],gender [male:35.4% (99) vs 55.4% (41),P =0.002],time of target potential before QRS onset [(37.9 ± 16.2) msvs (31.3 ± 11.7) ms,P=0.008],procedure time [(85.1 ± 36.9) minvs (100.8 ± 45.5) min,P=0.017],fluoroscopic time [(12.3 ± 9.2) min vs (15.9± 10.8) min,P =0.028] and success rate (96.4% vs 89.2%,P =0.012).Conclusions Radiofrequency ablation of PVCs was a safe and effective method.Subjects with RV PVCs are younger and more females than subjects with LV PVCs.The radiofrequency ablation for RV PVCs was easier,and the success rate was higher than that for LV PVCs.
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