时向民,单兆亮,郭红阳,杨庭树,王玉堂

• 1:解放军总医院心内科
• 2:解放军总医院海南分院心内科

摘要(Abstract)：

目的观察扩张性心肌病合并束支折返性室性心动过速(bundle branch reentryventricular tachycardia,BBRVT)患者消融右束支后左心室功能的变化,探讨该消融方法治愈室速后对左心功能的长期影响。方法自2007年12月至2010年2月,12例扩张性心肌病合并阵发性室速,电生理检查证实为BBRVT,标测右束支电位后予以消融,比较术前及术后12个月患者左室射血分数(left ventricular ejection fraction,LVEF);左室舒张末内径(left ventricular end distolic diameter,LVEDD);左室收缩末容量(left ventricular end systolic volume,LVESV);主动脉瓣口速度时间积分(velocity time integral,VTI);主动脉与肺动脉瓣开放时间差(QAO-QP);纽约心功能分级(NYHA);6分钟步行距离(6minutes walk test,6-MWT);血浆脑钠肽前体(NT-proBNP)变化;心电图QRS宽度变化。结果 12例患者射频消融后随访1年均未再发作室速,与术前相比,术后12个月LVEF,VTI,NYHA,6-MWT均显著降低;LVEDD,LVESV,QAO-QP,NT-proBNP及QRS宽度均增加。结论束支折返性室速消融右束支后可造成左右室间以及左室内收缩的不同步,可能是术后左室功能进一步减低的机制,但不能完全排除扩张性心肌病自身发展的影响。

关键词(KeyWords)： 束支传导阻滞;心肌病,扩张型;导管消融术;心室功能,左

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 时向民,单兆亮,郭红阳,杨庭树,王玉堂

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