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目的 :观察特发性左心室性心动过速 (ILVT)患者经导管射频消融术 (RFCA)后体表心电图的变化 ,探讨RFCA手术成功的心电图观察指标。方法 :分析 2 0例ILVT患者RFCA术前和术后 12导联体表心电图的变化 ,并随访 3个月。结果 :2 0例ILVT患者的消融手术均获成功。术后 19例呈左后分支起源的患者Ⅱ、Ⅲ、aVF导联新出现 q波 ,R波电压较前增高 ,Ⅰ、aVL导联的S波加深 ;QRS波群电压增加 ,心电轴度数不同程度增加 ;1例呈左前分支起源的患者术后Ⅱ、Ⅲ、aVF导联S波加深 ,aVL导联R波增高伴有电轴左偏。 2 0例患者术前、术后QT间期 ,QTd和QTc间期、QTcd均差异无统计学意义 (P >0 .0 5 ) ,随访 3个月 ,以上体表心电图未见进一步改变。结论 :体表心电图新出现左侧分支阻滞图形可作为ILVT患者成功RFCA的重要观察指标 ,术中标测最早肯浦野 (P)电位比最早心室激动点处消融更有效 ,术中体表心电图肢体导联的QRS波群电压幅值的改变 ,可作为消融成功的指征。ILVT经RFCA后不会影响心室肌复极离散度
OBJECTIVE: To observe the changes of surface electrocardiogram after radiofrequency catheter ablation (RFCA) in patients with idiopathic left ventricular tachycardia (ILVT), and to explore the successful electrocardiographic observation of RFCA. Methods: The changes of the 12-lead surface electrocardiogram before and after RFCA in 20 ILVT patients were analyzed and followed up for 3 months. Results: Twenty patients with ILVT had successful ablation. In 19 cases with left posterior branch originated from patients with Ⅱ, Ⅲ, aVF lead appeared q-wave, R wave voltage was higher than before, Ⅰ, aVL lead S wave deepened; QRS wave group voltage increases, ECG axis In one case, the S wave of Ⅱ, Ⅲ, aVF lead was deepened in one patient with left anterior branch origin. R wave in aVL lead increased accompanied by left deviation of the electric axis. There was no significant difference in QT, QTd, QTc interval and QTcd among 20 patients before and after surgery, and no further changes were observed on the body surface ECG at 3 months follow-up. Conclusion: The appearance of the left branch of the body surface ECG block diagram can be used as an important indicator of successful RFCA in patients with ILVT, intraoperative mapping the earliest Ken Po field (P) potential than the earliest ventricular activation point ablation is more effective, intraoperative surface ECG body Lead QRS complex voltage amplitude changes, can be used as an indication of successful ablation. ILVT after RFCA will not affect the ventricular repolarization dispersion