儿童左心室特发性室性心动过速临床特点及射频消融治疗

摘要

Objective: The purpose of this study was to analyze the clinical features and the effect of radiofrequency catheter ablation ( RFC A ) for idiopathic left ventricular tachycardia ( ILVT) in children. Methods : Eleetrophysiological study and radiofrequency catheter ablation were performed on 56 consecutive patients, and the target of ILVT was the site of earliest P potential on activation mapping in septal portion. Pacing and activation sequence mapping were used for LOT and VT originating from the left anterior fascicle in the ablation. The ablation target of LOT was where 12-lead pacing ECG was entirely consistent with IVT attacks. The successful target was that IVT could not be induced by repeated programmed stimulation while intravenous isoprena-Ime was administered. Results: The successful ablation rate was 98.2% (54 /55) in left IVT. 3 patients (5. 5% ) recurrenced during follow-up period and 2 were successfully reablated. Conclusion; RFCA has high success rate and few complications in treatment for ILVT.%目的:观察儿童左心室特发性室性心动过速(idiopathic left ventricular tachycardia ILVT)的临床特征和射频导管消融(radiofrequency catheter ablation RFCA)治疗的效果.方法:56例ILVT患儿行心内电生理检查和RFCA治疗,左心室特发性VT(ILVT)起自间隔部者以最早的P电位处为靶点,左心室流出道VT(LOT)和左前间隔来源的IVT,均以起搏与VT发作时12导联心电图QRS波,形态完全相同处或最早心室激动处为靶点.消融终点为程序刺激或静点异丙肾上腺素室速不被诱发.结果:RF-CA治疗ILVT的成功率为98.2％,复发率为5.5％.IVT起源部位分别位于左心室后间隔部47例,左前间隔3例,左心室流出道6例.结论:ILVT的RFCA成功率高,并发症少.