Catheter Ablation of Idiopathic Left Ventricular Tachycardia
Catheter Ablation of Idiopathic Left Ventricular Tachycardia
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特发性左室心动过速的导管消融术
DOI：
10.1111/j.1540-8159.1995.tb06965.x
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
R. Yee
中科院分区：
文献类型：
--
作者：
M. Zardini;R. Thakur;G. Klein;R. Yee
扎迪尼（M.一个独特的临床实体。 13）的复发性VT为16±16年，平均频率为4±3次/年。左心室的频率前电位和/或左心室的起搏。形态，平均周期长度（Cl）为361±61 ms。在3例患者中，RF获得了左心室的左心室。平均总过程为282±51分钟，平均荧光镜时间为40±15分钟17±13个月的随后，没有VT回报或其他心血管事件。当前者无效时。
ZARDINI, M., etal.: Catheter Ablation of Idiopathic Left Ventricular Tachycardia. Idiopathic left ventricular tachycardia (ILVT) characterized by right bundle branch block, left axis morphology, response to verapamil and inducibility from the atrium in patients without structural heart disease may represent a distinct clinical entity. We report our experience with catheter ablation of this uncommon arrhythmia using radiofrequency energy (RF) and/or direct current (DC) shocks. Six men and 2 women, aged 16–50 years (mean ± SD, 32 ± 13), had recurrent VT for 16 ± 16 years with a mean frequency of 4 ± 3 episodes/ year. Three patients had syncope during VT. None had identifiable structural heart disease. Catheter ablation was guided by earliest endocardial activation, presence of a high frequency presystolic potential and/or pacemapping of the left ventricle. The left ventricle was accessed via a retrograde aortic approach in 6 patients, a transeptal approach in 1 patient, and a combined approach in the remaining patient. All patients had inducible right bundle branch block morphology, left axis VT with a mean cycle length (CL) of 361 ± 61 ms. A presystolic potential preceding ventricular activation and the His potential during VT was identified in 4 patients. All ablation sites were identified in a relatively uniform location, in the inferoapical left ventricle. Noninducibility of VT was obtained with RF in 3 patients and with DC in 5 patients. In 1 patient, DC delivery after unsuccessful RF prevented further inducibility. Similarly, RF was successful in 1 patient in whom an initial DC attempt was ineffective. Mean total procedure time was 282 ± 51 minutes and mean total fluoroscopy time was 40 ± 15 minutes. There were no complications. One patient treated with DC shock had recurrence of VT during treadmill test the day after ablation and refused repeat ablation. During a mean follow‐up of 17 ± 13 months, no VT recurrences or other cardiovascular events occurred. In conclusion, catheter ablation in the inferoapical left ventricle is an effective treatment for this type of ILVT. RF energy can be safely complemented by low energy DC shocks when the former is ineffective.