虚拟单极电图在右室流出道心律失常射频消融中的价值

殷然; 李宾公; 付勇南; 文渊; 彭景添; 王梦洪; 郑泽琪

doi:10.13201/j.issn.1001-1439.2016.03.007

虚拟单极电图在右室流出道心律失常射频消融中的价值

- 南昌大学第一附属医院心内科(南昌, 330006)
基金项目:
2014年江西省卫计委科技计划项目(No:700431003)

详细信息

通讯作者: 殷然,E-mail:1378516386@qq.com

中图分类号: R541.7

收稿日期: 2015-09-24

Value of virtual unipolar electrogram in radiofrequency ablation for patients with premature ventricular beat/ventricular tachycardia originating from right ventricular outflow tract

- Department of Cardiology 1st Affiliated Hospital of Nanchang University, Nanchang, 330006, China

More Information

Corresponding author: YIN Ran, E-mail: 1378516386@qq.com

Received Date: 24 September 2015

摘要

摘要: 目的:分析应用Ensite Array三维电解剖系统对右室流出道(RVOT)室性期前收缩/心动过速进行(PVC/VT)射频消融过程中,消融点虚拟单极电图的形态特征。方法:35例RVOT-PVC/VT患者应用EnSite Array系统进行标测消融,术后随机抽取无效消融点与对应的有效消融点,回顾性测量分析两组虚拟单极电图形态特征。结果:有效消融点处的局部最早激动较体表QRS波起始提前时间(V-QRS)、局部S波起始激动3 ms以后的高度(S3)、5 ms以后的高度(S5)值显著高于无效消融点(均P<0.05);相反,有效消融点处的r波起始至S波最低点的时间(r-S)、起始r波的高度(r)值显著低于无效消融点(均P<0.05);而最大负向波S的高度(Smax)、局部S波起始激动10 ms以后的高度(S10)值两组间差异无统计学意义。多因素回归分析提示V-QRS及S5是消融是否有效的独立危险因素,其中,S5对消融是否有效具有最强的预测价值(OR=4.918,95%CI:1.622~14.593,P<0.05),其次为V-QRS(OR=3.625,95%CI:1.027~11.945,P<0.05)。结论:具有特征形态的虚拟单极电图在RVOT-PVC/VT射频消融中具有重要的预测价值。
- 室性期前收缩 /
- 射频消融 /
- 三维标测 /
- 单极电图
Abstract: Objective:To evaluate the virtual unipolar electrogram configuration of premature ventricular beat/ventricular tachycardia (PVC/VT) originating from right ventricular outflow tract (RVOT), which is obtained during ablation procedure guided by Ensite Array system. Method:The subjects consisted of 35 patients with RVOT-PVC/VT who underwent EnSite Array-guided ablation. We compared the virtual unipolar electrograms recorded at successful ablation sites with those recorded at unsuccessful sites.Result:The time interval between the first deflection and the QRS onset (V-QRS), voltage amplitudes of the initial negative slope at time phases of 3ms (S3), and 5ms (S5 ) were significantly higher at successful ablation sites than at unsuccessful sites (P<0.05). On the contrary, the time interval between the onset of r wave to the deepest part of S wave (r-S) and voltage amplitudes of the initial positive deflection (r) were significantly lower at successful ablation sites than at unsuccessful sites (P<0.05). The values of maximum voltage amplitudes of the S wave (Smax) and voltage amplitudes of the initial negative slope at time phases of 10ms (S10) were similar between two groups. Multi-factor regression analysis indicated V-QRS and S5 were independent risk factor predicting successful ablation. The odd ratio (OR) and confidential intervals (CI) for S5 and V-QRS were 4.918, 1.622-14.593 and 3.625, 1.027-11.945, respectively (P<0.05).Conclusion:Virtual unipolar electrogram with specific morphology has great predictive value in radiofrequency ablation of RVOT-PVC/VT.
- premature ventricular beat /
- radiofrequency ablation /
- non-contact mapping /
- unipolar electrogram

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参考文献(10)

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