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Radiofrequency catheter ablation for idiopathic premature ventricular contractions originating from outflow tract and long-term follow-up study

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Journal Title:
China Clinical Practical Medicine
Key Word:
室性早搏;射频消融;心室流出道;左室心功能;Radiofrequency catheter ablation;Premature ventricular contractions;Ventricular outflow tract;Left ventricular cardiac function

Abstract´╝Ü Objective:To study and summarize the efficacy of radiofrequency catheter ablation in the treatment of idiopathic premature ventricular contractions(PVCs)originating from outflow tract, and to explore the origin of PVCs.Methods:This study was a retrospective study, a total of 512 patients with when the 12-lead surface electrocardiograms(ECGs)were consistent with the characteristics of origin from the outflow tract who underwent radiofrequency ablation for idiopathic PVCs in department of Cardiology in General Hospital of Northern Theater Command from January 2019 to December 2021 were selected, 206 males, 306 females, aged(50.77±14.14)years old.ranging from 16 to 82 years old, The clinical characteristics, intraoperative ablation data, short-term and long-term clinical efficacy were summarized.Results:There were 380 patients with PVCs originating from the right ventricular outflow tract(RVOT)and 132 patients with PVCs originating from left ventricular outflow tract(LVOT). After(21.5±11.3)months of follow-up, the long-term success rate of PVCs originating from RVOT were 92.6%(352/380), and from LVOT were 80.3%(106/132). Delayed efficacy was observed in 6 patients after ablation, and occasional PVCs appeared during long-term follow-up.The acute success rates[95.8%(364/380)]and long-term success rates[92.6%(352/380)]of PVCs originating from RVOT were higher than those of PVCs originating from LVOT[85.6%(113/132)and 80.3%(106/132)], and the differences were statistically significant( P<0.05). There was no statistically significant difference in number of PVCs originating from RVOT and LVOT during 24h Holter monitoring( P>0.05). The left ventricular ejection fraction[LVEF, (60.44±5.59)%]of patients with PVCs originating from RVOT was significantly higher than LVEF of patients with PVCs originating from LVOT[(58.12±7.93)%], and the difference was statistically significant( P<0.05). There was statistically significant difference in PVCs originating from LVOT, the patients with PVCs originating from RVOT was significantly lower in age[(49.02±13.52)years old, (55.81±14.71)years old], proportion of male[34.2%(130/380), 57.5%(76/132)], N-terminal pro-brain natriuretic peptide[NT-ProBNP, 95.06(42.12, 198.75)pg/ml, 132.00(67.00, 286.00)pg/ml], left ventricular end-diastolic dimension[LVEDD, (47.82±5.15)mm, (50.83±5.49)mm]and operation duration[20.00(10.00, 40.00)min, 50.00(20.50, 87.00)min], and the differences were statistically significant( P<0.05). No acute or long-term complications occurred in all cases. Conclusions:Radiofrequency catheter ablation is a safe, effective and feasible method for ventricle outflow tract PVCs.

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