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目的:探讨心室流出道图形室性期前收缩(ventricular premature beat,VPB)心电图特征及射频消融治疗的疗效、安全性。方法:对28例心室流出道图形VPB的心电图特征进行分析并行射频消融治疗。结果:心室流出道图形12导联心电图特征:Ⅰ导联呈rs、M、R、QS型,aVR均呈QS型,aVL呈rs、R、QS型,Ⅱ、Ⅲ、aVF、V5、V6呈单向R波。胸前导联R波的移行部位:右心室流出道起源V3、V4导联,左心室流出道起源V1导联。28例全部消融成功,其中27例在右心室流出道消融成功,1例在左心室流出道消融成功。手术操作时间50~162 min,X线曝光时间10~30 min。随访3~28个月,均无复发,也无严重并发症发生。结论:心室流出道图形VPB有独特的心电图特征,射频消融治疗是安全、有效的根治方法。
Objective: To investigate the ECG characteristics of ventricular premature beats (VPB) and the efficacy and safety of radiofrequency catheter ablation in ventricular outflow tract. Methods: The electrocardiographic features of VPB in 28 cases of ventricular outflow tract were analyzed and compared with radiofrequency ablation. Results: Ventricular outflow tract pattern 12 leads ECG characteristics: Ⅰ lead was rs, M, R, QS type, aVR were QS type, aVL rs, R, QS type, Ⅱ, Ⅲ, aVF, V5, V6 was Unidirectional R wave. Thoracic lead R wave migration sites: the origin of right ventricular outflow tract V3, V4 leads, the origin of left ventricular outflow tract V1 lead. Totally 28 cases were successfully ablated, of which 27 cases succeeded in ablation of the right ventricular outflow tract and 1 case succeeded in the ablation of the left ventricular outflow tract. Operation time 50 ~ 162 min, X-ray exposure time 10 ~ 30 min. Follow-up of 3 to 28 months, no recurrence, no serious complications. Conclusions: VPB has a unique electrocardiographic feature. Radiofrequency catheter ablation is a safe and effective radical method.