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目的:探讨在常规方法消融困难的左室特发性室性心动过速(ILVT)患者中室间隔左室面线性消融的有效性。方法:18例术中不能诱发持续性心动过速或发作时不能耐受患者,进行室间隔左室面心尖到心底部连线的前1/3~1/2区域,在窦性心律下首先标到蒲肯野氏纤维电位(PP),向下至室间隔与左室下壁交界、向上至前后间隔中线进行线性消融,术后门诊或电话随访。结果:所有患者术后即刻均未能诱发出ILVT。随访3~35(23±13)个月,3例/18例(17%)复发,远期成功率达83%,无1例发生永久性的并发症。结论:对于术中不能诱发持续性心动过速或发作时不能耐受的ILVT患者,室间隔左室面线性消融安全有效,可以作为补救性消融措施。
Objective: To investigate the efficacy of linear ablation of the left ventricular septum in patients with left ventricular idiopathic ventricular tachycardia (ILVT) with conventional ablation. Methods: 18 patients with intraoperative ventricular tachycardia can not induce persistent tachycardia or attack can not tolerate patients with interventricular septal left apex to the bottom of the connection of the heart of the former 1/3 ~ 1/2 area in sinus rhythm first Mark the Purkinje fiber potential (PP), down to the interventricular septum and lower left wall, up to the anteroposterior midline linear ablation, postoperative clinic or telephone follow-up. Results: All patients failed to induce ILVT immediately after operation. Followed up for 3 ~ 35 (23 ± 13) months, 3 cases / 18 cases (17%) had recurrence. The long-term success rate was 83%. No permanent complications occurred in 1 case. Conclusions: Linear interventricular septal linear ablation is safe and effective for ILVT patients who can not induce persistent tachycardia or seizure during operation. It can be used as a remedial ablation measure.