Analysis Of Clinical Efficacy And Electrophysiological Characteristics In70Cases Of Patients With Ventricular Premature Beats Treated By Radiofrequency Catheter Ablation

OBJECTIVES:To analyze the clinical characteristics and electrophysiological characteristics of PVCs,evolute the therapeutic effect in patients with PVCs treated by RFCA。METHODS:Retrospective analysis70cases of patients of The First Affiliated Hospital of Guangxi Medical University with premature ventricular beats (PVBs) whom were treated with radiofrequency catheter ablation (RFCA), which between the date2012May to2013November.23male cases,47female cases, age43±16years, the maximum age was74years old, the youngest was10years old. Analyze their electrocardiographic characteristics, the target position, discharge time, operation time, complications, success rate of ablation, recurrence rate were statistically analyzed and evaluated.RESULTS:Within the70patients,68cases of operation instant success, the success rate was97.1%;7cases recurrence and reoperation in one month, reoperation were successful; Long term follow-up of48cases,39cases had no recurrence,9cases of recurrence,22patients were lost to follow-up, the success rate of long-term follow-up was84.7%, the recurrence rate was15.3%. Left ventricular target advance degree is smaller than right ventricular (P=0.017<0.05), left ventricular originated PVCs comparison of right ventricular originated instant success rate of operation had no significant difference (P=0.267), long-term follow-up success rate had no significant difference (P=0.661)。Of inferior wall R wave showed sensitivity to predict double-apex form originating from the right ventricular free wall was81.8%, the specificity was88.9%, the positive predictive value was64%, The negative predictive value was95%; Negative or positive and negative wave on lead I showed the sensitivity was60%to prediction that the target was in the front,while the specificity was73.3%, the positive predictive value was78.9%, the negative predictive value was52%. The migration of precordial lead QRS R wave showed less relationship to the the target’s location。CONCLUSION:1、Radiofrequency ablation is a mature technology, It has been used in Therapy of PVCs with high success rate and less complications。It is a safe and effective way to treat frequent premature ventricular beat.2、Numbers of cases that of Left ventricular origin PVCs less than that of right ventricular origin(14.3%VS85.7%), target’s potential advance degree of left ventricular origin less than that of right ventricular originated; Operation time of the left ventricular PVCs is longer than that of the right ventricular PVCs.3、For RVOT PVCs, an inferior R wave morphology in double-apex indicates that the PVCs originated from the free wall side; A negative wave or short Amplitude RS form wave on lead I suggested that the target is on the front; The migration of precordial lead QRS R wave has limited value for locating the target。...