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目的:观察非接触式球囊标测系统(EnSite3000系统)指导右室心肌病并复杂性室性心动过速(室速)射频消融的有效性。方法:右室心肌病并室速2例患者经心室刺激诱发出室速后,使用EnSite3000系统标测室速的起源点、出口和(或)慢传导区,然后使用温控大头导管在室速起源点和出口作环形消融或横跨慢传导区进行线性消融。术后反复刺激并异丙肾上腺素诱发。结果:2例患者术中均分别诱发出3种不同形态、不同频率的室速,其中2种起源于右室流出道中间隔,2种来源于下后壁,2种起源于侧后壁,均消融成功。静滴异丙肾上腺素均未诱发室速,术中、术后无任何并发症发生。随访7～8个月,服用胺碘酮0.2qd,美托洛尔12.5mg/qd或bid,未发作心动过速。结论:EnSite3000系统能成功指导右室心肌病并复杂性室速的射频消融。
Objective: To observe the effectiveness of non-contact balloon mapping system (EnSite3000 system) in radiofrequency catheter ablation of right ventricular cardiomyopathy and complicated ventricular tachycardia (VT). Methods: Two patients with right ventricular cardiomyopathy and ventricular tachycardia were induced ventricular tachycardia after ventricular stimulation. EnSite3000 system was used to detect the origin, exit and / or slow conduction of VT. Circular ablation of origin and exit or linear ablation across the slow conduction area. After repeated stimulation and isoproterenol-induced. Results: Three kinds of ventricular tachycardia were induced in the two patients during operation. Two of them originated from the middle of the right ventricular outflow tract, two from the posterior wall of the posterior wall, and two originated from the posterior wall of the posterior wall Ablation success. Intravenous isoproterenol intravenous infusion did not induce VT, intraoperative and postoperative without any complications. Follow-up 7 to 8 months, taking amiodarone 0.2qd, metoprolol 12.5mg / qd or bid, did not attack tachycardia. Conclusion: The EnSite 3000 system successfully instructs radiofrequency ablation of RV cardioversion and complex VT.