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致心律失常性右室发育不良中难治性室性心动过速的电极导管消融:13例患者的经验及平均45个月的随访

Electrode catheter ablation of resistant ventricular tachycardia in arrhythmogenic right ventricular dysplasia: experience of 13 patients with a mean follow-up of 45 months.

作者信息

Fontaine G, Frank R, Rougier I, Tonet J L, Gallais Y, Farenq G, Lascault G, Lilamand M, Fontaliran F, Chomette G

机构信息

Service de Rythmologie, Hôpital Jean Rostand, Ivry, France.

出版信息

Eur Heart J. 1989 Sep;10 Suppl D:74-81. doi: 10.1093/eurheartj/10.suppl_d.74.

Abstract

Electrode catheter ablation (fulguration) is a new technique for the treatment of ventricular tachycardia resistant to medical treatment. It proved effective in our hands in a series of 65 cases of ventricular tachycardia of varied origin. This paper reports the early results in a subgroup of 13 patients suffering from arrhythmogenic right ventricular dysplasia in whom shocks ranging from 160 to 280J, single or multiple, in one or up to three sessions were delivered. In the 11 patients surviving the DC ablation procedure single or multiple monomorphic sustained VT was brought under control. However, four patients (36%) required therapeutic antiarrhythmic treatment following the fulguration therapy. During the learning phase one case of death was related to poor catheter selection and the other to poor protocol. The post-mortem study of the effect of shocks depends on the anatomical structure to which the shocks have been delivered.

摘要

电极导管消融(电灼)是一种治疗药物难治性室性心动过速的新技术。在我们手中,它在一系列65例不同起源的室性心动过速病例中被证明是有效的。本文报告了13例致心律失常性右心室发育不良患者亚组的早期结果,这些患者接受了160至280焦耳的单次或多次电击,电击在一次或多达三次疗程中进行。在直流电消融手术存活的11例患者中,单形性持续性室性心动过速单次或多次发作得到了控制。然而,4例患者(36%)在电灼治疗后需要抗心律失常治疗。在学习阶段,1例死亡与导管选择不当有关,另1例与方案不当有关。电击效果的尸检研究取决于电击所施加的解剖结构。

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