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导联1中S波与右心室流出道室性早搏消融复发之间的关系。

The relationship between the S-wave in lead 1 and recurrence of RVOT PVC ablation.

作者信息

Güneş Hacı Murat, Demir Gültekin Günhan, Karaca Oğuz, Yılmaz Filiz Kızılırmak, İbişoğlu Ersin, Gökdeniz Tayyar, Omaygenç Mehmet Onur, Güler Ekrem, Güler Gamze Babur, Savur Ümeyir, Çakal Beytullah, Barutçu İrfan, Kılıçaslan Fethi

机构信息

Medipol University Faculty of Medicine, Cardiology Department, Istanbul, Turkey.

Medipol University Faculty of Medicine, Cardiology Department, Istanbul, Turkey.

出版信息

J Electrocardiol. 2018 May-Jun;51(3):519-523. doi: 10.1016/j.jelectrocard.2017.12.033. Epub 2017 Dec 14.

DOI:10.1016/j.jelectrocard.2017.12.033
PMID:29277286
Abstract

BACKGROUND

Radiofrequency catheter ablation (CA) is a common non-pharmacological treatment option for ventricular premature contractions (PVCs) originating from right ventricular outflow tract (RVOT). In this study, we aimed to investigate the relationship between recurrence after CA for RVOT-PVC and S-wave in lead 1 that was shown to be associated with RVOT depolarization.

METHODOLOGY

A total of 104 patients who were referred to our clinic for CA for idiopathic RVOT-PVC between 2012 and 2015years were enrolled. All ECG parameters were measured before and after the ablation procedure.

RESULTS

Ablation was successful in 100 patients (96,1%). These patients with successful ablation were followed for a mean duration of 1078days. 13 patients (13%) had recurrence. Univariate logistic regression analysis revealed age (odds ratio: 1.916, p:0,012), presence of post-procedural S1 (odds ratio:1.040 p:0,028), post-procedural S1 area (oddsratio:1.023 p:0,041), ΔS1 area (odds ratio:1.242 p:0,004) as predictors for recurrence. Multivariate logistic regression analysis detected age (odds ratio:1.053 p:0,032) and ΔS1 area (odds ratio:0.701 p:0,009) as predictors for recurrence.

CONCLUSION

Radiofrequency CA for RVOT-PVC can be performed with high procedural success and low complication rates. Age and ΔS1 area might be helpful for prediction of recurrence after CA.

摘要

背景

射频导管消融术(CA)是起源于右心室流出道(RVOT)的室性早搏(PVC)的一种常见非药物治疗选择。在本研究中,我们旨在探讨RVOT-PVC导管消融术后复发与Ⅰ导联S波之间的关系,该S波已被证明与RVOT去极化有关。

方法

纳入2012年至2015年间因特发性RVOT-PVC到我院接受导管消融术的104例患者。在消融术前和术后测量所有心电图参数。

结果

100例患者(96.1%)消融成功。这些消融成功的患者平均随访1078天。13例患者(13%)复发。单因素逻辑回归分析显示年龄(比值比:1.916,p:0.012)、术后S1波的存在(比值比:1.040,p:0.028)、术后S1波面积(比值比:1.023,p:0.041)、ΔS1波面积(比值比:1.242,p:0.004)是复发的预测因素。多因素逻辑回归分析发现年龄(比值比:1.053,p:0.032)和ΔS1波面积(比值比:0.701,p:0.009)是复发的预测因素。

结论

RVOT-PVC的射频导管消融术可获得较高的手术成功率和较低的并发症发生率。年龄和ΔS1波面积可能有助于预测导管消融术后的复发情况。

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