室性心动过速的导管消融：潜在病因及能量传递部位的作用

Catheter ablation of ventricular tachycardia: role of the underlying etiology and the site of energy delivery.

作者信息

Trappe H J, Klein H, Auricchio A, Wenzlaff P, Lichtlen P R

机构信息

Department of Cardiology, University Hospital Hannover, Germany.

出版信息

Pacing Clin Electrophysiol. 1992 Apr;15(4 Pt 1):411-24. doi: 10.1111/j.1540-8159.1992.tb05137.x.

DOI:10.1111/j.1540-8159.1992.tb05137.x

PMID:1374886

Abstract

The role of DC catheter ablation (CA) to treat patients with sustained monomorphic ventricular tachycardia (VT) is still debated. To assess the efficacy of VT CA, we studied the follow-up of 49 patients with VT who underwent CA. There were 33 patients with an old myocardial infarction (MI) (group G I) and 16 patients had noncoronary VT (group G II): CA was performed at the earliest endocardial activation (EEA) (20 patients in G I, 14 patients in G II) or at the area of slow conduction (ASC) (13 patients in G I, 2 patients in G II). During the mean follow-up of 35 +/- 25 (1-79) months, there were 17 patients in G I (52%) and 12 patients in G II (75%) with VT recurrences (P less than 0.05). Recurrences of VT was observed in 4 of 15 patients (27%) when CA was performed at the ASC, compared to 25 of 34 patients (74%) with CA at the EEA (P less than 0.01). These data show that DC CA is more successful in patients with coronary artery disease, particularly when CA is performed at the ASC.

摘要

直流电导管消融术（CA）治疗持续性单形性室性心动过速（VT）患者的作用仍存在争议。为评估VT CA的疗效，我们研究了49例行CA的VT患者的随访情况。其中33例有陈旧性心肌梗死（MI）（G I组），16例为非冠心病性VT（G II组）：CA在最早心内膜激动（EEA）处进行（G I组20例，G II组14例）或在缓慢传导区（ASC）进行（G I组13例，G II组2例）。在平均35±25（1 - 79）个月的随访期间，G I组有17例（52%）、G II组有12例（75%）出现VT复发（P<0.05）。在ASC处进行CA时，15例患者中有4例（27%）出现VT复发，而在EEA处进行CA时，34例患者中有25例（74%）出现VT复发（P<0.01）。这些数据表明，直流电CA在冠心病患者中更成功，尤其是在ASC处进行CA时。