中文摘要：

目的探讨零射线下单导管进行左心室室性早搏（室早）射频消融治疗的可行性及安全性。方法2015年8月至10月连续入选上海交通大学附属第一人民医院因频发性左心室室早行射频消融治疗的6例患者，平均年龄（46．6±20．9）岁，男4例。术中常规穿刺右股动脉，建立股动脉通路后，借助三维标测系统（Carto3），零射线下将三维标测消融导管经股动脉逆行主动脉送至左心室。三维重建左心室解剖结构后，进行室早的激动标测，寻找室早最早激动点进行消融。术中常规药物激发并观察30min，术后规律随访，评价手术疗效及安全性。结果6例左心室室早均在零射线下经单导管顺利完成标测及消融，室早分别起源于左后分支（1例）、左前分支（3例）、左心室后乳头肌（1例）、二尖瓣环（1例），其最早激动较体表QRS时限提前（29．5±6．7）ms，即刻手术成功率100％。术后患者均无手术相关并发症，随访（9．2±1．0）个月，除1例患者左心室后乳头肌室早复发，其余患者均无明显室早，中远期手术成功率83．3％。结论借助三维标测系统，零射线下单导管射频消融治疗左心室室早是安全可行的。

英文摘要：

Objective In this study,we investigated the safety and feasibility of radiofrequency cathe- ter ablation（RFCA） by single catheter for left ventricular premature contractions （PVC） under the guidance of three-dimensional mapping system without radiation exposure. Methods A total of 6 consecutive patients with frequent PVC originated from left ventricle[ male 4, （46. 6±20. 9） years old] ,who underwent RFCA guided by a three-dimensional mapping system（ Carto 3）with single catheter,were included in this study. Activation map- ping and ablation were performed by single mapping and ablating catheter. Drug stimulation and a 30-minute ob- servation period were routinely performed after success ablation. A regular follow-up was performed to evaluate the safety and effectiveness of RFCA. Results During procedure, all PVCs were eliminated successfully with- out radiation exposure. The sites of origin of PVCs included 1 left posterior branch （ n = 1 ） , left anterior branch （ n = 3 ）, left ventrieular posterior papillary muscle（ n = 1 ） and 1 mitral annulus （ n = 1 ）. The immediate success rate was 100% without any complications. During a follow-up period of （9. 2±1.0） months,frequent PVC re- curred only in 1 patient（ left ventrieular posterior papillary muscle）. Conclusion Under the guidance of three- dimensional mapping system,it was safety and feasibility to performed RFCA by single catheter without radiation exposure for frequent PVC originating from left ventricle.