目的：探讨主动脉瓣下左右冠窦小叶间三角消融作为难治性左心室顶部室性期前收缩（室早）治疗策略的有效性、安全性及预后。方法：前瞻性纳入2022年3月—2024年2月于上海交通大学医学院附属瑞金医院行室早消融术的症状性频发左心室顶部室早患者21例。所有患者双侧心室流出道瓣上及瓣下位置激动标测均未发现满意靶点电位，首选主动脉瓣下左右冠窦小叶间三角消融，并观察急性期疗效、消融参数及远期预后。结果：21例患者体表心电图具有异质性，经小叶间三角消融后，19例（90.5%）获得急性期成功，随访12个月，17例（81.0%）无室早复发。所有患者均未发生手术相关并发症。结论：对于激动标测无满意靶点的左心室顶部起源室早，主动脉瓣下左右冠窦小叶间三角消融可作为一种有效策略。

Objective To discuss the efficacy, safety and prognosis of ablation at the right-left subvalvular interleaflet triangle as the primary strategy for refractory premature ventricular contractions originating from the left ventricular summit. Methods 21 patients with frequent symptomatic left-ventricular-summit-originated premature ventricular contractions who underwent ablation at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between March 2022 and February 2024 were included. In all these cases, no satisfactory target potential was identified by activation mapping of the supra-valvular and sub-valvular positions of the bilateral ventricular outflow tracts. Ablation was then prioritized to be performed at the right-left subvalvular interleaflet triangle, and its acute efficacy, ablation parameters and long-term prognosis were recorded. Results While the surface electrocardiograms of the 21 patients showed heterogeneous characteristics, ablation at interleaflet triangle achieved acute success in 19 patients (90.5%). During a 12-month follow-up, 17 patients (81.0%) had no recurrence of premature ventricular contractions. No surgical complications occurred. Conclusions For left-ventricular-summit-originated premature ventricular contractions with no satisfactory target through activation mapping, ablation at the right-left subvalvular interleaflet triangle can be applied as the primary strategy.