影响流出道室性早搏患者射频消融成功率的心电图参数。
Electrocardiogram Parameters That Affect the Success Rate of Radiofrequency Ablation in Patients with Outflow Tract Ventricular Premature Complexes.
机构信息
Department of Rheumatology, Ningde Municipal Hospital of Ningde Normal University, Fujian 352000, China.
Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, China.
出版信息
Cardiovasc Ther. 2022 Jul 22;2022:8160144. doi: 10.1155/2022/8160144. eCollection 2022.
OBJECTIVES
The objectives of this study are to assess the efficacy of radiofrequency catheter ablation (RFCA) in patients with outflow tract (OT) ventricular premature complexes (VPCs) and to explore the electrocardiographic (ECG) features of initially successful procedures.
METHODS
Based on the outcome of ablation, 154 consecutive patients with OT-VPCs who underwent RFCA from January 2017 to December 2019 were divided into two groups. The rate of successful procedures and the ECG features were analyzed and compared between the two groups.
RESULTS
The highest success rate was found in patients with VPCs from the right ventricular outflow tract (RVOT), and the lowest success rate was evident among patients with complexes from both the RVOT and the left ventricular OT (LVOT). The patients with successful procedures (136) reflected a lower pseudo delta wave ratio (16.2% vs. 44.4%, < 0.01), a smaller R-wave amplitude in lead V1 (V1) (0.23 ± 0.24 mV vs. 0.35 ± 0.44 mV, < 0.05), shorter intrinsicoid deflection time in lead V2 (V2) (44.00 ± 18.33 ms vs. 57.41 ± 20.67 ms, < 0.01), a shorter RS duration in V2 (93.67 ± 21.33 ms vs. 106.93 ± 18.76 ms, P < 0.01), and smaller R/S-waveratios in V2. Furthermore, multivariate analysis demonstrated that RS duration in V2 was above 109.17 ms and R/S ratio in V2 was above 0.28, forecasting a failed procedure.
CONCLUSIONS
The ECG predictors of failed ablation were characterized by RS duration and R/S ratio in V2.
目的
本研究旨在评估射频导管消融（RFCA）治疗流出道（OT）室性早搏（VPC）的疗效，并探讨首次成功手术的心电图（ECG）特征。
方法
根据消融结果，将 2017 年 1 月至 2019 年 12 月间 154 例接受 RFCA 治疗的 OT-VPC 患者分为两组。分析比较两组患者的手术成功率和心电图特征。
结果
右心室流出道（RVOT）来源的 VPC 患者的成功率最高，RVOT 和左心室流出道（LVOT）均有 VPC 的患者的成功率最低。手术成功的患者（136 例）伪 delta 波比（16.2%比 44.4%， < 0.01）、V1 导联（V1）R 波振幅（0.23 ± 0.24 mV 比 0.35 ± 0.44 mV， < 0.05）、V2 导联（V2）固有电延迟时间（44.00 ± 18.33 ms 比 57.41 ± 20.67 ms， < 0.01）、V2 导联 RS 持续时间（93.67 ± 21.33 ms 比 106.93 ± 18.76 ms，P < 0.01）和 V2 导联 R/S 比值较小。此外，多变量分析表明，V2 导联 RS 持续时间超过 109.17 ms 和 V2 导联 R/S 比值超过 0.28 预测手术失败。
结论
V2 导联 RS 持续时间和 R/S 比值是消融失败的心电图预测指标。
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