Darrieux Francisco C C, Scanavacca Maurício I, Hachul Denise T, Melo Sissy L, D'Avilla André B, Gruppi César J, Moffa Paulo J, Sosa Eduardo A
Instituto do Coração, Hospital das Clínicas, FM, USP, São Paulo, SP, Brazil.
Arq Bras Cardiol. 2007 Mar;88(3):265-72. doi: 10.1590/s0066-782x2007000300003.
To evaluate if radiofrequency catheter ablation is an effective procedure for the treatment of right ventricular outflow tract premature ventricular contractions (RVOT-PVC) and ascertain if it results in an improvement of symptoms.
A prospective study with 30 consecutive patients (mean age 40 +/- 13 years, 25 females), with no apparent structural cardiopathy, with very frequent (mean density of 1,263 +/- 593/h) RVOT-PVC, symptomatic for more than one year (mean = 74 months) and resistant to antiarrhythmic drugs (3 +/- 1.7, including beta-blockers), who underwent radiofrequency catheter ablation.
After the first procedure, there were 23 initial successful cases (76.6%) and 7 initial failures (23.4%). Four patients experienced relapses, two of whom did not undergo the second procedure. The second procedure was carried out in 9 patients (7 initial failures and 2 relapses), and there was success in 5 additional patients, one of them by epicardial access. The final success rate was 80% (24/30), and there were no major complications. After a mean follow-up of 14 +/- 6 months, in the successful group there was a reduction greater than 90% in density of premature ventricular contractions (PVC) (24/24; p<0.0001) and a resulting absence of symptoms in the majority of patients (23/24; p<0.001).
Radiofrequency catheter ablation is a safe and effective treatment for patients with persistent and symptomatic PVC with RVOT morphology.
评估射频导管消融术是否是治疗右心室流出道室性早搏（RVOT - PVC）的有效方法，并确定其是否能改善症状。
一项前瞻性研究，纳入30例连续患者（平均年龄40±13岁，25例女性），无明显结构性心脏病，RVOT - PVC非常频繁（平均频率为1263±593次/小时），有症状超过一年（平均74个月）且对抗心律失常药物耐药（3±1.7种，包括β受体阻滞剂），接受射频导管消融术。
首次手术后，有23例初始成功病例（76.6%）和7例初始失败病例（23.4%）。4例患者复发，其中2例未接受第二次手术。9例患者（7例初始失败和2例复发）接受了第二次手术，另外5例患者成功，其中1例通过心外膜途径。最终成功率为80%（24/30），无重大并发症。平均随访14±6个月后，成功组室性早搏（PVC）频率降低超过90%（24/24；p<0.0001），大多数患者无症状（23/24；p<0.001）。
射频导管消融术是治疗持续性且有症状的RVOT形态PVC患者的一种安全有效的方法。
