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本文报告冠心病引起的内科治疗无效的持续的单形性室性心动过速在电生理标测指引下进行冷冻治疗的效果。对象为61±9岁的39(男34,女5)例冠心病所致室速患者。各例均有心肌梗塞(MI)病史,发生冷冻治疗前85±84个月,部位如下:前壁16例;下壁22例;前壁+下壁1例。主要的临床表现为:心跳骤停18例,晕厥11例,先兆晕厥8例,心绞痛2例。所有病例均用过多种抗心律失常药物治疗无效。术前电刺激诱发持续性室速48次,其中 QRS 波呈右束支传导阻滞形占62%,呈左束支传导阻滞形占38%。
This article reports the results of cryogenic therapy guided by electrophysiological mapping of persistent monomorphic ventricular tachyarrhythmia caused by coronary heart disease. Subjects were 61 ± 9-year-old 39 (34 males and 5 females) patients with ventricular tachycardia due to coronary heart disease. Each case had a history of myocardial infarction (MI), 85 ± 84 months before cryotherapy, the site is as follows: anterior wall in 16 cases; inferior wall in 22 cases; anterior wall + inferior wall in 1 case. The main clinical manifestations were: cardiac arrest in 18 cases, syncope in 11 cases, aura of syncope in 8 cases, 2 cases of angina pectoris. All cases were treated with a variety of anti-arrhythmic drugs ineffective. Preoperative electrical stimulation induced a sustained VT of 48 times. Among them, QRS wave showed right bundle branch block (62%) and left bundle branch block (38%).