摘要
目的回顾分析His束旁室性早搏(PVCs)的心电图(ECG)特点和射频消融方法。方法选择2005年至2011年5月间的7例His束旁的PVCs,并与136例起源于右室流出道(RVOT)的PVCs的12导联ECG进行对比分析并总结射频消融治疗的经验。结果与起源于RVOT的PVCs ECG对比,起源于His束旁PVCs的12导联ECG中aVL导联多表现为振幅较低,多以R波为主。V1导联多为QS型(85.7%),胸前导联移行区多发生于V2～V3导联(71.4%)。7例均在His束电极附近标测到最早心室激动。5例一次消融成功;1例1周后再次消融成功;1例因消融电极几乎与His电极重叠而放弃手术。结论 His束旁PVCs在体表ECG上完全可以进行鉴别,射频消融术可以根治此类PVCs。
Objective To investigate electrocardiogram （ECG） characteristics of premature ventricular contractions （PVCs） originating near the His-bundle, and the methods of mapping and radiofrequeney catheter ablation. Methods Seven patients with PVCs originating near the His-bundle were selected since 2005. ECG variables were compared with 136 patients with PVCs originating from right ventricular outflow tract（RVOT）. All patients were underwent catheter mapping and radiofrequency ablation. Results Compared with PVCs originating from RVOT, ECG of PVCs originating near the His-bundle had a R wave in lead aVL, and a QS pattern in V1 （ 85.7% ） ,the precordial R-wave transition occurred at V2 -V3 （71.4%）. The earliest ventricular activation was observed close to the His-bundle in seven patients. Successful abla- tion was achieved in five patients at first time, one patient was ablated again after a week, the remaining one patient was not ablated, because the ablation catheter was overlapped to His-bundle electrode. Conclusion PVCs originating near the His-bundle have distinctive ECG characteristics,and radiofrequency catheter ablation can cure this kind of PVCs.
出处
《中国心脏起搏与心电生理杂志》
2012年第4期295-298,共4页
Chinese Journal of Cardiac Pacing and Electrophysiology
关键词
电生理学
His束
室性早搏
心电图
房室传导阻滞
Electrophysiology
His-bundle
Premature ventricular contractions
Electrocardiogram
Atrioventricular conduction block
