摘要
目的探讨磁导航指导下心房颤动（简称房颤）导管消融的可行性和安全性。方法对22例房颤患者穿刺房间隔后，采用盐水灌注磁消融导管行左房建模和左右肺静脉电位隔离，永久性房颤加房顶线和／或峡部线消融。消融温度前壁和后壁均设定为48℃，前壁消融能量40～45W，后壁消融能量30～35W，每点消融时间30～60s或电位幅度下降80％，盐水灌注流量消融和未消融状态下分别为17ml／min和2ml／min。肺静脉电位隔离结束后，采用“牛眼图”确认，同时观察和记录手术操作时间、X线暴露时间、X线暴露量和手术相关并发症。结果22例房颤患者均成功实现肺静脉电位隔离，手术操作时间（153．4±22．8）min，其中建模及肺静脉电位隔离时间（111．3±15．3）mn，消融时间（33．1±5．6）min，X线暴露时间（18．2±7．7）min，X线暴露量（665．4±506．7）mGy，未发生心包压塞和栓塞等严重并发症。结论应用磁导航可成功对房颤患者进行标测和消融，且安全可行，学习曲线短。
Objective To investigate the feasibility and safety of atrial fibrillation （AF） catheter ablation guided by magnetic navigation system （MNS）. Methods Left atrial model establishment and circumferential pulmonary vein isolation were performed in 22 AF patients with irrigated tip magnetic catheter after their atrial septa were punctured. Atrial roof line and/or isthmus line were added in permanent AF. Temperature during ablation was 48℃ both in anterior and posterior walls. Powers were 40-45W in anterior wall and 30-35 W in posterior wall. Ablation time was 30-60 s or 80% decrease in potential amplitude in each site. The flow rates in ablation and non-ablation were 17ml/min and 2ml/min respectively. ＂ Bull＇s eye map＂ was applied to confirm the isolation of pulmonary vein. The procedure time, X-ray exposure time, X-ray dose and procedure-related complications were observed and recorded. Results Circumferential pulmonary vein isolation was successfully performed in all 22 AF patients. The procedure time was （153.4±22.8） min, including （ 111.3 ± 15.3 ） min for left atrial model establishment and pulmonary vein isolation, （33.1 ±5.6） min for ablation. X-ray exposure time and X-ray dose were （18.2±7.7） min and （665.4±506.7） mGy respectively, without cardiac tamponade, embolism and other serious complications occurred in all cases. Conclusions MNS can be used successfully to perform mapping and ablation in AF patients, which is safe and feasible with a short learning curve.
出处
《中国心脏起搏与心电生理杂志》
2014年第2期105-109,共5页
Chinese Journal of Cardiac Pacing and Electrophysiology
基金
江苏省医学重点人才资助项目(RC201134)
江苏省无锡市社会发展科技支撑项目(CSE32N1302)
关键词
心血管病学
磁导航
心房颤动
导管消融
Cardiology
Magnetic navigation system
Atrial fibrillation
Catheter ablation
