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目的探讨单极起搏标测法在右室流出道室性心动过速(室速)和频发室性早搏(室早)射频消融术中的应用。方法选择99例特发性右室流出道室速或频发室早的患者,随机分为两组,一组采用常规起搏标测法及激动顺序标测法,另一组在常规标测法的同时加用单极起搏标测法进行标测,比较两组的手术成功率及消融功率、消融温度、放电时间、放电次数和平均阻抗。结果加用单极起搏标测法治疗组与对照组相比手术成功率分别是(48/50)96.0%,(46/49)93.8%,两组比较无显著性差异。但加用单极起搏标测法治疗组的消融功率、消融温度、放电时间及放电次数均低于常规标测法治疗组,且两组比较P<0.05,有显著性差异。结论在导管消融治疗右室流出道特发性室速或频发室早过程中,加用单极起搏标测法可用较低的功率、温度进行消融治疗,并缩短了靶点标测时间,提高准确性,从而提高了手术效率。
Objective To explore the application of unipolar pacing method in radiofrequency ablation of ventricular tachycardia (VT) and premature ventricular contractions (RVS) in right ventricular outflow tract. Methods Ninety-nine patients with idiopathic right ventricular outflow tract ventricular tachycardia or frequent ventricular ejection fraction were randomly divided into two groups. One group received conventional pacing and excitatory sequence mapping, Law plus monopolar pacing mapping method for mapping, the two groups of surgical success rate and ablation power, ablation temperature, discharge time, the number of discharges and the average impedance. Results Compared with the control group, the successful rate of monopolar pacing method was (48/50) 96.0% and (46/49) 93.8%, respectively. There was no significant difference between the two groups. However, the ablation power, ablation temperature, discharge time and number of discharges in the treatment group with monopolar pacing were lower than those in the conventional mapping method, and there was significant difference between the two groups (P <0.05). Conclusions In the course of catheter ablation of right ventricular outflow tract in idiopathic ventricular tachycardia or asymptomatic ventricular tachycardia, monopolar pacing method can be used for ablation with lower power and temperature, and the time of target mapping can be shortened , Improve the accuracy, thus improving the operation efficiency.