摘要
目的:探讨CARTO三维标测系统两种建模方法结合在阵发性心房颤动射频消融术中应用的安全性及有效性。方法:150例接受射频消融治疗的阵发性心房颤动患者随机分为3组,A组(n=50):常规点对点方式建模引导心房颤动的环肺静脉隔离术;B组(n=50):快速解剖建模方式构建左心房及肺静脉模型作为环肺静脉消融的路标指导消融。C组(n=50):点对点标测构建左心房模型,肺静脉定口完成后用快速解剖标测方法构建环肺静脉前庭,确认定口的准确性后再行房颤的射频消融。三组患者术中其余操作步骤及方法均相同。分别记录三组手术操作时间,X线曝光时间,成功率及并发症的发生率。超声心动图测量术前与术后6个月左心房大小及左心室收缩功能变化。结果:C组手术操作时间及X线曝光时间均明显低于A、B组(P<0.05),C组成功率略高于A组及B组,但差异无统计学意义。三组患者均无严重并发症的发生。超声心动图检测显示术后6个月左心房大小及左心室射血分数与术前相比无明显变化。结论:CARTO两种建模方法结合指导房颤的射频消融是安全、有效的,可减少手术操作时间及X线曝光时间,提高环肺静脉定口的准确性,对心房颤动的射频消融具有一定的指导意义。
Objective： To explore the safety and efficacy of two modeling methods of CARTO3 system for radiofrequency catheter ablation （RFCA） in paroxysmal atrial fibrillation （PAF） patients. Methods： A total of 150 PAF patients with RFCA were randomly divided into 3 groups： Group A： using conventional point-to-point mapping to guide circumferential pulmonary vein isolation; Group B, using fast anatomical modeling to guide circumferential pulmonary vein RFCA; Group C, using combined application of 2 mapping methods to guide circumferential pulmonary vein RFCA. n=50 in each group and the rest operative procedures were the same in 3 groups. The operative time, X-ray exposure time, success rate and complication rates were recorded in 3 groups; the size of left atrium and systolic function of left ventricle at pre- and 6 months post-operation were compared. Results： Compared with Group A and Group B, Group C had the shorter operative time and X-ray exposure time, P〈0.05;the success rates were similar among 3 groups. No serious complication occurred in all 3 groups. Echocardiography presented that compared with pre-operative condition, the size of left atrium and LVEF were similar at 6 months post-operation. Conclusion： Combined using of two modeling methods of CARTO3 system was safe and effective for RFCA in PAF patients; it may reduce the operative time and X-ray exposure time, improve the accuracy of circumferential pulmonary vein locating and help guiding RFCA of PAF at certain degree.
出处
《中国循环杂志》
CSCD
北大核心
2017年第12期1208-1212,共5页
Chinese Circulation Journal
基金
心血管核磁共振扫描与3D影像实时重建结合CARTO3三维电解剖标测在复杂快速心律失常射频消融术中的应用(黔科合SY字2015[3045])
关键词
CARTO三维标测
心房颤动
导管消融术
CARTO mapping system
Atrial fibrillation
Radiofrequency catheter ablation
