摘要
目的探讨致心律失常左心室心肌病(ALVC)室性心动过速(室速)患者行射频消融的即刻结果与长期预后效果。方法本研究为回顾性、横断面研究。选取2011年1月至2018年12月于南京医科大学第一附属医院就诊并行射频消融术的ALVC室速患者,收集其年龄、性别、超声心动图检查结果等基本临床信息,记录术中电生理检查和三维标测结果。射频消融术后每6个月至门诊随访,随访截至2021年8月,记录患者超声心动图复查结果以及室速的复发情况。结果共纳入12例ALVC室速患者,年龄(42±15)岁,男性11例(11/12)。心功能均在正常范围,左心室舒张末期内径(51±5)mm,左心室射血分数(61±5)%。电生理检查共在10例患者中诱发出12种室速,周期(298±67)ms。三维标测提示12例患者中有1例基质位于内膜,其余11例均在外膜(其中2例也累及内膜),心脏基底部近瓣环处是基质好发部位(10/11)。分别于内膜及外膜行射频消融后,所有患者达到完全手术终点(所有室速不再诱发)。中位随访时间65(25,123)个月,1例失访,其余11例患者均存活,且无室速复发。随访截止时的超声心动图复查结果显示,与术前相比,左心室舒张末期内径[(52±5)mm比(51±5)mm,P>0.05]和左心室射血分数[(60±6)%比(65±5)%,P>0.05]无明显变化。结论射频消融术后即刻,ALVC室速患者均达到完全手术终点。长期随访结果表明这些患者室速均未复发,且心功能未发生明显改变。
Objective To investigate the acute and long-term outcome of catheter ablation for the treatment of ventricular tachycardia(VT)in patients with arrhythmogenic left ventricular cardiomyopathy(ALVC).Methods This retrospective,cross-sectional study enrolled ALVC patients undergoing radiofrequency ablation for the treatment of VT at the First Affiliated Hospital of Nanjing Medical University from January 2011 to December 2018 and collected their clinical characteristics and intraoperative electrophysiological examination.Patients were followed up every 6 months after radiofrequency ablation until August 2021.Echocardiographic results and VT recurrence post radiofrequency ablation were analysed.Results Totally 12 patients were enrolled(mean age:(42±15)years,11 males(11/12)).The mean of left ventricular end diastolic diameter(LVDd)and left ventricular ejection fraction(LVEF)were(51±5)mm and(65±5)%,respectively.Twelve VTs were induced in 10 patients during the electrophysiological study,and the mean tachycardia cycle length was(293±65)ms.Three-dimensional substrate mapping revealed the diseased area at endocardial site in one patient,at epicardial sites in the other 11 patients(involved endocardial sites in 2 cases)with the basal part near the mitral annulus being the predilection for the substrate(10/11).After the catheter ablation at the endocardial and epicardial sites respectively,the complete procedure endpoint was achieved in all patients(VT cannot be induced post ablation).The median follow-up time was 65(25,123)months.One patient was lost to follow-up,and the other 11 patients survived without VT.No significant cardiac function deterioration was detected by the echocardiographic examination((51±5)mm vs.(52±5)mm,P>0.05 for LVDd,(65±5)%vs.(60±6)%,P>0.05 for LVEF)at the end of follow-up.Conclusion After radiofrequency ablation,the complete procedure endpoint is achieved in ALVC patients,and the catheter ablation provides long-term ventricular tachycardia control during the long-term follow-up.
作者
王哲
施林生
刘海雷
王子盾
姜晓宏
陈红武
杨刚
顾凯
居维竹
陈明龙
Wang Zhe;Shi Linsheng;Liu Hailei;Wang Zidun;Jiang Xiaohong;Chen Hongwu;Yang Gang;Gu Kai;Ju Weizhu;Chen Minglong(Department of Cardiology,First Affiliated Hospital of Nanjing Medical University,Nanjing 210000 China;Department of Cardiology,Second Affiliated Hospital of Nantong University,Nantong 226001,China)
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2022年第6期549-555,共7页
Chinese Journal of Cardiology
关键词
心肌疾病
室性心动过速
射频消融
随访
起搏
Cardiomyopathies
Ventricular tachycardia
Radiofrequency ablation
Follow-up
Cardiac pacing
