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目的:探索Carto标测指导下,双极射频消融术治疗室壁瘤相关室性心动过速的可行性。方法:14头实验猪利用左侧肋间小切口冠状动脉缝扎法建立猪急性心肌梗死(AMI)模型。建模6~8周后对左心室造影证实有室壁瘤的模型猪诱发持续室性心动过速(VT)。将可诱发VT的模型猪随机分为射频组和对照组。射频组行基质标测,解剖定位缓慢传导区,然后进行双极射频消融术(BRF)。BRF后,两组模型猪再次诱发VT。评价BRF的可行性。结果:14头猪建模6~8周后存活10头,左心室造影证实8头形成室壁瘤,其中7头可诱发持续VT。射频组5头,对照组2头。射频组均成功施行了基质标测下BRF,无手术死亡。术后射频组80%模型猪VT不可诱发,而对照组100%可诱发VT(P<0.05)。结论:Carto标测指导下BRF在室壁瘤相关VT模型的应用是可行的,即刻控制VT是有效的。
Objective: To explore the feasibility of bipolar radiofrequency ablation under the guidance of Carto mapping in the treatment of ventricular aneurysm related ventricular tachycardia. Methods: 14 experimental pigs were used to establish acute myocardial infarction (AMI) model by using left intercostal coronary incision. Model 6-to 8-week modeling of pigs with left ventricular angiography confirmed aneurysm induced sustained ventricular tachycardia (VT). VT-induced model pigs were randomly divided into radiofrequency group and control group. Radiofrequency imaging was performed on the stroma, the slow conduction area was anatomized, and bipolar radiofrequency ablation (BRF) was performed. After BRF, two groups of model pigs again induced VT. Evaluate the feasibility of BRF. RESULTS: Twenty-four pigs survived 6 to 8 weeks after modeling, and 8 of them formed ventricular aneurysms by left ventricular angiography. Seven of them were able to induce persistent VT. RF group 5 head, control group 2 head. Radiofrequency group were successfully performed under the matrix markers BRF, no surgical death. Eighty percent of the model pigs in the radiofrequency group were not induced by VT, while 100% of the control group could induce VT (P <0.05). CONCLUSION: The application of BRF in the VT model of ventricular aneurysm under the guidance of Carto mapping is feasible, and immediate control of VT is effective.