Adams Jonathon C, Srivathsan Komandoor, Shen Win K
Division of Cardiovascular Diseases (JCA, KS, WKS), Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.
J Interv Card Electrophysiol. 2012 Nov;35(2):137-49. doi: 10.1007/s10840-012-9698-x. Epub 2012 Aug 9.
Premature ventricular complexes (PVCs) are a common occurrence in clinical practice. The clinical presentation may range from asymptomatic to left ventricular (LV) dysfunction with congestive heart failure. The decision to suppress PVCs is largely based on the presence of symptoms, interference with other therapy (e.g., cardiac resynchronization therapy), or suspicion of PVC-mediated cardiomyopathy. Catheter ablation has emerged as a safe and effective option for the treatment of frequent PVCs. Careful attention to PVC characteristics on surface electrocardiogram has proven useful for the initial localization of the ectopic focus, which may then serve as a guide to procedural planning. The point of interest is often identified with activation mapping, and the ablation site can be further defined with pace mapping techniques. Clinical experience with PVC ablation has been successful in ≥80 % of cases, and the literature reports multiple cases of marked improvement in LV function after eradicating the culprit ectopic focus in patients with PVC-mediated cardiomyopathy.
室性早搏（PVCs）在临床实践中很常见。临床表现可能从无症状到伴有充血性心力衰竭的左心室（LV）功能障碍不等。是否抑制PVCs的决定很大程度上基于症状的存在、对其他治疗的干扰（如心脏再同步治疗）或怀疑PVC介导的心肌病。导管消融已成为治疗频发PVCs的一种安全有效的选择。仔细关注体表心电图上的PVC特征已被证明有助于异位灶的初步定位，这随后可作为手术规划的指导。感兴趣的点通常通过激动标测来确定，消融部位可通过起搏标测技术进一步明确。PVC消融的临床经验在≥80%的病例中取得了成功, 并且文献报道了多例在根除PVC介导的心肌病患者的罪魁祸首异位灶后左心室功能显著改善的病例。
