中文摘要：

目的比较致心律失常性右心室心肌病（ARVC）合并室性心动过速（VT）单纯心内膜与心内外膜联合导管射频消融即刻成功率与远期随访结果。方法回顾性分析2006年1月至2015年7月就诊于广东省人民医院并被确诊为ARVC同时合并VT的患者临床基线、电生理资料及随访结果，分为单纯心内膜标测消融（ENDO）组和联合心内外膜标测消融（ENDO．EPI）组，共49例患者纳入研究，其中ENDO组35例，ENDO．EPI组14例。结果经导管射频消融治疗后，ENDO．EPI组的导管消融即刻成功率显著高于ENDO组（92．9％对62．9％，P=0．042）。在平均（28．9±18．1）个月的随访中，所有患者无VT事件存活率为36．7％，其中ENDO—EPI（71．4％对22．9％，P=0．045）和以不能诱发VT作为消融终点（47．2％对7．7％，P=0．015）均可显著提高患者的无VT存活率。而ENDO—EPI组中达到即刻成功终点的患者的随访无VT事件率可达76．9％。结论射频消融是治疗ARVC合并VT的有效手段；心内膜与心外膜联合标测消融和以不能诱发VT作为消融终点可以显著提高患者的远期随访无Ⅵ’存活率。

英文摘要：

Objective To determine the outcomes of ventricular tachycardia（VT） control after endo- cardial（ENDO） and adjuvant epicardial（EPI） ablation strategy in patients with arrhythmogenic right ventricu- lar cardiomyopathy（ARVC）. Methods The study reviewed the patients with Task Force criteria for ARVC referred for VT ablation in Guangdong province cardiovascular institute from January 2006 to July 2015.Patients were categorized into only ENDO strategy group（ ENDO group） and ENDO adjuvant EPI strategy group（ ENDO- EPI group）.The clinical baselines, electrophysiological profiles, prognostic data and complications were collect- ed and analyzed. Results Forty-nine patients were enrolled in the present study.ENDO-EPI ablation strategy was performed in 14 patients.During mean follow-up of （28.9±18.1） months ,VT free survival was 36.7% in all the patients.ENDO-EPI ablation strategy（71.4% vs.22.9% ,P= 0.045） and ablation endpoint for noninducibili- ty of any VT（ 47.2% vs.7.7%, P = 0.015 ） both significantly improved VT free survival. Furthermore, VT free survival was 76.9% in patients with combination of ENDO-EPI ablation strategy and ablation endpoint for noninducibility of any VT. Conclusion The outcome after ENDO-EPI ablation strategy of VT in ARVC was positive.Both ENDO-EPI ablation strategy and ablation endpoint for nonindueibility of any VT significantly im- proved VT free survival.