Aizawa Y, Chinushi M, Naitoh N, Kitazawa H, Washizuka T, Uchiyama H, Shibata A
First Department of Internal Medicine, Niigata University, Japan.
Am J Cardiol. 1995 Sep 15;76(8):574-9. doi: 10.1016/s0002-9149(99)80158-1.
During catheter ablation with radiofrequency (RF) currents, the incidence of the termination of reentrant ventricular tachycardia (VT) during application of RF energy and the morphologic change of the reinduced VT were analyzed. Twenty-five patients (20 men and 5 women, aged 44 +/- 17 years) were studied. After induction of monomorphic sustained VT, the ablation site was determined by endocardial activation mapping, identification of isolated mid-diastolic potential, and pacing during tachycardia. Thirty-six monomorphic VTs were induced in 25 patients and terminated with programmed stimulation. The cycle length was 323 +/- 55 ms and all VTs were entrained with rapid ventricular pacing. The target site was the earliest site of activation of VT in 26 VTs in 16 patients, and the area of slow conduction in 10 VTs in 9 patients. VT was terminated soon after the application of RF currents in 33 VTs in 22 patients at 6.0 +/- 3.1 seconds, and VT was induced immediately after the cessation of RF currents in 11 patients. Of these, 4 patients with idiopathic left ventricular VT had an alternation in the QRS configuration before catheter ablation and required repeat ablation of the other VT morphology. In the other 7 patients, such morphology was not observed before ablation, but was observed in VT induced when the original VT was terminated. Repeated attempts of catheter ablation 2 to 9 times at the remapped site was, however, successful in 7 of 8 VTs.(ABSTRACT TRUNCATED AT 250 WORDS)
在使用射频（RF）电流进行导管消融期间，分析了在施加RF能量时折返性室性心动过速（VT）终止的发生率以及再次诱发的VT的形态学变化。研究了25例患者（20例男性和5例女性，年龄44±17岁）。诱发单形性持续性VT后，通过心内膜激动标测、识别孤立的舒张中期电位以及心动过速时的起搏来确定消融部位。25例患者诱发了36次单形性VT，并通过程序刺激终止。心动周期长度为323±55毫秒，所有VT均被快速心室起搏拖带。16例患者中26次VT的靶点是VT最早激动部位，9例患者中10次VT的靶点是缓慢传导区域。22例患者中33次VT在施加RF电流后6.0±3.1秒很快终止，11例患者在RF电流停止后立即诱发VT。其中，4例特发性左心室VT患者在导管消融前QRS形态有改变，需要对另一种VT形态进行重复消融。在另外7例患者中，消融前未观察到这种形态，但在原VT终止后诱发的VT中观察到了。然而，在重新标测的部位进行2至9次重复导管消融尝试后，8次VT中有7次成功。（摘要截短至250字）
