To Explore Different Parts Of Ventricular Premature Beat Three Dimensional Characteristic Of Standard Measuring Voltage Under The Standard Test

Objective: To explore different parts of ventricular premature beat three dimensional characteristic of standard measuring voltage under the standard test.Ventricular premature beat(PVC)is more common type of arrhythmia, clinical routine electrocardiogram inspection, the period before the contract accounts for about 14%, of which half of ventricular premature beat, is second only to the room premature beat a common type of arrhythmia, ranked second. According to the domestic for a number of studies have found that the incidnce of ventricular premature beat in the normal group was 68%, in organic heart disease group, ventricular premature beat detection rate is 81%, comparing the two groups have significant difference(P < 0.01), ventricular premature beat that not only can be found in the general population(including all age groups), and most often occurs in patients with organic heart disease. Ventricular premature beat can exist for a long time and continuous attack, flustered, pharynx causedpatients discomfort such as tight. Especially frequent ventricular premature beat, potentially cause the risk of malignant arrhythmia, easily affect daily life or work. Frequent ventricular premature beat seriously affect the patients quality of life. Because of the complexity of the organic heart disease caused by ventricular premature beat, this article only discusses patients without organic heart disease. In the organic heart disease, the origin of ventricular premature beat point is different, different mechanism, prognosis, eliminate electrolyte disorders, autonomic nervous tension changes, drugs and other outside factors, the rest of the ventricular premature beat RF ablation treatment requires the removal of lesion, clinical cure is achieved, anddifferent sources of ventricular premature beat there may be different methods of melting. Therefore different origin of ventricular premature beat, indicates the different treatment options. Always have explored a variety of ablation methods treating ventricular arrhythmia, the practice proved to be effective, and the prognosis is good, because of ablation has become a current of non-drug therapy for the treatment of ventricular indispensable part. Excited standard measurement and pacemaker standard combined with clinical measurement has been part of the study, discusses the two share the benefit.But excited order standard test the joint, pacemaker standard test voltage standard test research is still less for the treatment of ventricular arrhythmia. Past research voltage standard test in patients with organic heart disease, especially in ARVC is more, more used to the scar area, measuring the degree of fatty infiltration, assess myocardial survival ratio, discusses the influence of cardiac function. Recent studies have found that only a small number of cases of a few, the end of the income of the research direction in right ventricular outflow tract ventricular arrhythmias, the left ventricular outflow tract, aortic sinus, left the place such as papillary muscle, mitral valve ring source- ofventricular arrhythmia whether clinical reports have not been able to application. This research attempts to improve ventricular premature beat by a variety of standard test methods radio frequency ablation target accuracy, may improve the success rate of ablation, reduce operation and X-ray exposure time.Methods: Selection Fuwai hospital in October 2013 to September 2014, 105 cases of premature beat, preoperative stop taking at least five half-life anti-arrhythmic drugs, according to the ECG analysis considering source of right ventricular outflow tract of puncture right femoral vein, consider the sources of left ventricular outflow tract or aortic sinus puncture right internal jugular vein, internal femoral vein and femoral artery from right; Conventional into HIS electrode and/or CS electrode catheter and bulk ablation catheter, X-ray fluoroscopy auxiliary ablation catheter in place. Interventional operation for puncture of femoral artery give 2000 u common heparin static note first, later added 1000 u/H. In CARTO3 for navigation, excited to establish standardtest right ventricular outflow tract or left ventricular outflow tract or aortic sinus three-dimensional excited figure, is converted to a voltage by CARTO system standard, after ablation catheter in transitional zone, high and low pressure area standard test to determine ablation targets. For outsiders, premature pacemaker standard measurement to locate, Pacemaker standard12-lead electrocardiogram characteristics should be measurement and clinical patients with spontaneous 12-lead electrocardiogram of ventricular premature beat the same or nearly the same, or at least more than 10 of 12 lead guide league match; Excited the electrocardiogram(ECG) measurement is spontaneous ventricular premature beat QRS complex in advance more than 20 ms. In left and right ventricular outflow tract standard measurement without ideal target, for aortic sinus measurement. Set the melting temperature of 43 ℃, the melting power 20 to 25 w, cold saline perfusion flow of 17 ml/min, such as put some 30 s no response to the test, if effective, melting is target to expand ablation area, consolidate the 180 s. Under the guidance of Carto excited standard measurement, pacemaker standard measuring ablation of ventricular arrhythmia, through the Carto system converts three-dimensional excited figure 3 d voltage model, the ablation target in the distribution of voltage model. Comparison of left ventricular system source, right ventricular system source and the source of aortic sinus ablation method of ventricular premature beat, recording operation time, record the X-ray exposure time.Results: Define voltage < 0.5 m V abnormalities endocardial region for dense scar, is located in the area between the normal myocardial and scar tissue as the zone, the voltage at 0.5-1.5 m V. Right ventricular outflow tract interval on the origin of successful ablation target is located in the transition zone of voltage 48/48(100%), origin of ventricular premature beat free wall ablation target voltage transition zone 12/14(85%), Left ventricular outflow tract, aortic sinus ventricular premature beat in the transition zone, or in high or in low pressure area.Conclusion: Excited standard test the joint, pacemaker standard test voltage standard measurement improve the origins of right ventricular outflow tract ventricular premature beat melting takes effect, reduce the X-ray exposure time; This method is used in left ventricular outflow tract and aortic sinus area did not benefit of ventricular premature beat.