导管倒'U'型方法消融肺动脉窦源性室性心律失常

摘要

Objective To summarize the ablation methods,and to provide experience reference for the treatment of pulmonary since cusp(PSC)-derived ventricular arrhythmia(VA)with ablation. Methods A retrospective analysis of the clinical data of 19 patients undergoing catheter ablation for PSC-derived VA in Cardiac Intervention Therapy Center,The Second Xiangya Hospital of Central South University between January 2013 and March 2016 was conducted. Results Among the 19 patients,PSC-derived VA originated from the lower regions of the pulmonary sinuses,generating from the right,left,and anterior sinuses of the PSC were identified in 5,7,and 7 patients,respectively. Twelve patients with PSC-derived VAs originating from the right and anterior sinuses underwent successful reversed U-curve catheter ablation,while the other 7 patients with arrhythmias originating from the left sinus underwent successful ablation with the conventional method(non-reversed U-curve catheter ablation). All the patients were followed-up for 6 to 31 months,and no recurrence of VA or complications were recorded. Conclusions Reversed U-curve catheter ablation is suitable for VA originating from the right and anterior PSCs,while conventional ablation can be used for those originating from the left PSCs.%目的 总结肺动脉窦源性室性心律失常的消融方法,为肺动脉窦源性室性心律失常的消融治疗提供可以借鉴的经验.方法 回顾性分析和总结2013年1月至2016年3月在中南大学湘雅二医院进行射频消融的19例肺动脉窦源性室性心律失常患者的临床资料.结果 19例肺动脉窦源性室性心律失常患者的起源点均位于肺动脉窦底部,5例起源于肺动脉右瓣窦,7例起源于左瓣窦,7例起源于前瓣窦.对于12例起源于右瓣窦及前瓣窦,采用导管倒"U"型方法成功消融;而对起源于左瓣窦的7例,采用常规方法(非导管倒"U"型)成功消融.随访6～31个月,无复发及并发症发生.结论 导管倒"U"型消融方法适合应用于肺动脉右瓣窦及前瓣窦起源的室性心律失常.而起源点位于肺动脉左瓣窦时采用常规方法消融较安全.