| Objective:To analyze the clinical characteristics of patients with idiopathic ventricular arrhythmia and the risk factors related to the effect of radiofrequency catheter ablation.Methods:142 patients with ventricular arrhythmia who received radiofrequency catheter ablation in the Department of Cardiology of Qianfoshan Hospital of Shandong Province from January 2013 to May 2019 were enrolled retrospectively.The general clinical data of patients and operation-related information were collected by consulting hospital electronic medical records,the distribution of origin sites of idiopathic ventricular arrhythmia was analyzed,and the clinical characteristics of patients with different sites of origin and different types of idiopathic ventricular arrhythmia were compared.the effectiveness and safety of radiofrequency catheter ablation were evaluated according to the success rate of operation and the incidence of complications.According to the effect of radiofrequency catheter ablation,patients were divided into two groups:successful ablation group(n=128)and failure ablation group(n=14).Univariate analysis was conducted to analyze the differences in age,sex,history of smoking,history of coronary heart disease,history of hypertension,history of diabetes,history of oral antiarrhythmic drugs before operation,types of ventricular arrhythmia and origin of idiopathic ventricular arrhythmia.At the same time,the differences in the above factors between the two subgroups of idiopathic premature ventricular contractions and idiopathic ventricular tachycardia were analyzed.Multivariate logistic regression analysis was used to screen the factors affecting the efficacy of radiofrequency catheter ablation of idiopathic ventricular arrhythmia.Results:(1)General clinical features:142 patients were selected,including 68 males and 74 females,with an average age of 50.63±16.05 years.The main types of idiopathic ventricular arrhythmia were idiopathic premature ventricular contractions in 117 cases(82.39%)and idiopathic ventricular tachycardia in 25 cases(17.61%).The origin of idiopathic premature ventricular contractions was mainly from the right ventricular outflow tract in 83 cases(70.09%),and the origin of idiopathic ventricular tachycardia was mainly from the left posterior fascicular in 11 cases(44.00%).(2)The difference of clinical characteristics of patients with different types of idiopathic ventricular arrhythmia:the age of patients with idiopathic premature ventricular contractions(52.64±14.38years)was significantly higher than that of patients with idiopathic ventricular tachycardia(41.20±20.05years),and the proportion of female patients with idiopathic premature ventricular contractions(58.12%)was significantly higher than that of idiopathic ventricular tachycardia(24.00%)(P<0.05).The incidence of hypertension in patients with idiopathic premature ventricular contractions(35.90%)was higher than that in patients with idiopathic ventricular tachycardia(8.00%)(P<0.05),and the incidence of diabetes in patients with idiopathic premature ventricular contractions(14.53%)was higher than that in patients with idiopathic ventricular tachycardia(0%)(P<0.05).(3)Differences in clinical characteristics of patients with idiopathic ventricular arrhythmia of different origins:there were gender differences in patients with idiopathic ventricular arrhythmia of different origins(P<0.001).The proportion of female patients with idiopathic ventricular arrhythmia originating from the right ventricular outflow tract(68.89%)was higher than that of other sites(31.11%)and the left ventricular outflow tract(9.38%).The proportion of male patients with idiopathic ventricular arrhythmia originating from other sites(90.62%)was higher than that of right ventricular outflow tract(31.11%)and left ventricular outflow tract(55.00%).(4)Analysis of the factors affecting the success rate of radiofrequency catheter ablation of idiopathic ventricular arrhythmia:the success rate of radiofrequency catheter ablation of idiopathic ventricular arrhythmia was 90.14%.Intraoperative complications occurred in 3 cases(2.11%).Univariate analysis showed that there were significant differences in age,history of hypertension,history of coronary heart disease and origin of ventricular arrhythmia between successful radiofrequency catheter ablation group and failed group in idiopathic ventricular arrhythmia(P<0.05).There were significant differences in the history of hypertension,the history of coronary heart disease and the origin of arrhythmia between the successful ablation group and the failed ablation group in idiopathic premature ventricular contraction(P<0.05).There was only significant difference in age between the successful ablation group and the failed ablation group in idiopathic ventricular tachycardia(P<0.05).Multivariate logistic regression analysis showed that the origin of idiopathic premature ventricular contractions was closely related to the effect of radiofrequency ablation,and the origin was an independent risk factor affecting the effect of radiofrequency ablation in patients with idiopathic premature ventricular contractions.Conclusion:There are differences in the distribution of origin sites of idiopathic ventricular arrhythmia.There are differences in gender,age,incidence of hypertension and diabetes between patients with idiopathic premature ventricular contraction and idiopathic ventricular tachycardia.There were gender differences among patients with idiopathic ventricular arrhythmia originating from right ventricular outflow tract,left ventricular outflow tract and other sites.Radiofrequency catheter ablation of idiopathic ventricular arrhythmia has high success rate,few complications,safe and effective operation.Age,history of hypertension,history of coronary heart disease and origin site of arrhythmia are factors affecting the effect of radiofrequency catheter ablation of idiopathic ventricular arrhythmia.the origin site is an independent risk factor affecting the effect of radiofrequency ablation of idiopathic premature ventricular contraction. |
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