摘要
目的探讨心室流出道频发室性早搏和／或室性心动过速的心电图特征及射频消融治疗的有效性及安全性。方法对14例（13例右心室流出道频发室性早搏和／或室性心动过速，1例左心室流出道频发室性早搏）的心电图特征进行分析并行射频消融治疗。结果右心室流出道室性早搏及室性心动过速体表12导联心电图QRS波特征：工导联呈rs、m、QS及R型，aVR、aVL均呈QS型，Ⅱ、Ⅲ、aVF、V5—6导联均呈单向R波型，胸前导联R波移行区常在V3、V3导联之后，V1、V2导联R高度／S高度比值常〈0．3。左心室流出道频发室性早搏和／或室性心动过速的QRS波特征与右心室流出道频发室性早搏和／或室性心动过速类似，但其胸前导联R波移行区常在v2导联之前，V1、V2导联（尤其V2导联）R高度／S高度比值常〉10．8。13例消融成功，手术操作时间45—156min，X线曝光时间8—28min。术后随访2—36个月，无复发病例。结论起源于心室流出道的频发室性早搏和／或室性心动过速有其独特的心电图表现，射频消融治疗能安全、有效地根治此类心律失常。
Objective To investigate the dectrocardiographic characteristics and assess the efficiency and safety of radiofrequery catheter ablation in ventricular tachycardia and ventricular premature contractions originating from the outflow tract. Methods The dectrocardiographic characteristics and the results d radiofrequency catheter ablation were anayzed in 14 （13cases ventricular tachycardia and ventricular premature contractions originating from right outflow tract and 1 case ventricular premature from left outflow tract）. Results The surface dectrocardiogram of ventricular tachycardia and ventricular premature contractions originating from fight outflow tract showed rs, m, QS or R wave on lead I. QS wave was seen on lead aVR and aVL. Tall R wave was seen on lead Ⅱ ,Ⅲ, aVF, V5 and V6. Precordial lead R wave transition occurred on lead V3 or behind it. The mean R/S wave amplitude on lead V1 and V2 was 〈 0.3. The surface electrocardiographic characteristics of ventricular premature contractions originating from left outflow tract were similar with above. But the precordial lead R wave transition was earlier than that on lead V2. The mean R/S wave amplitude on lead V1 and V2 was≥0.8. 13 of 14 patients with ventricular tachycardia and ventricular premature contractions were successfully abolished. The procedure time was 45 - 156 rain and the fluoroscopic time was 8 - 28 n-fin. During follow - up, there was no recurrence. Conclusions There are specific electrocardiographic characteristics in ventricular tachycantia and ventricular premature contractious originating from the outflow tract. The arrhythmia can be successfully and safely abolished by radiofrequenoy catheter sblation.
出处
《心脑血管病防治》
2006年第6期349-352,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
关键词
电生理学
室性心动过速
室性早搏
主动脉窦
右心室流出道
导管消融
射频电流
Electropbysiology
Ventricular tachycardia
Ventricular premature contractions
Aortic sinus cusp
Right outflow tract
Catheter ablation
Radiofrequency current.
