摘要
目的初步探讨应用压力监测消融导管治疗特发性右室流出道室性心律失常(RVOT-VAs)的临床疗效和安全性。方法将符合入选标准的拟行导管射频消融治疗的特发性RVOT-VAs病例分为两组,压力导管(CFC)组使用ThermoCoolSmartTouch压力导管进行射频消融,非压力导管(NCFC)组使用非压力导管进行射频消融。记录和比较两组病例的消融靶点、消融时间、无效放电次数、手术时间、X线曝光时间和曝光剂量等术中观察指标,并记录和比较两组病例的即刻成功率、单次手术成功率、再次手术和复发率等手术疗效指标和手术并发症等安全性指标。结果共纳入92例特发性RVOT-VAs患者,包括频发室性早搏患者77例,持续性室性心动过速患者15例,其中CFC组47例,NCFC组45例。CFC组的单次手术成功率明显高于NCFC组(93.6%vs 77.8%,P=0.029),且再次手术率更低(4.3%vs 17.8%,P=0.048),两组的即刻成功率、复发率和并发症发生率比较未达到统计学差异;CFC组的无效消融放电次数更少,总的手术时间较短(P<0.001),CFC组的X线曝光时间和剂量较低(P<0.05)。结论使用压力监测消融导管治疗特发性右室流出道室性心律失常的疗效和安全性优于非压力监测消融导管。
Objective To explore the efficacy and safety of catheter ablation of idiopathic right ventricular outflow tract arrhythmias(RVOT-VAs)using contact sensing ablation catheters.Methods Patients with idiopathic RVOT-VAs who were eligible for radiofrequency catheter ablation were included.In the contact force catheter(CFC)group,ThermoCoolSmartTouch catheters were used for radiofrequency ablation,and in non-contact force catheters(NCFC)group,radiofrequency ablation were performed with catheters without contact force sensing function.The ablation tartets,ablation time,number of ineffective ablation application,procedure time,X-ray exposure time and dose of the two groups were recorded and compared.Moreover,the success rate,single-operation success rate,reoperation rate and recurrence rate of the two groups were recorded and compared.Results In this clinical controlled study,92 patients with idiopathic RVOT-VAs were included,including 77 patients with frequent PVC and 15 patients with persistent VT.Among them,47 cases were in CFC group and 45 cases in NCFC group.The results showed that the single-procedure success rate in the CFC group was significantly higher than that in the NCFC group(93.6%vs 77.8%,P=0.029),and the reoperation rate was lower(P=0.048).The comparison results of acute success rate,recurrence rate and complication rate between the two groups showed no statistical difference.The CFC group presented a lower number of ineffective ablations with shorter total procedure time(P<0.001),while the X-ray exposure time and dose in the CFC group were lower too(P<0.05).Conclusion The efficacy and safety of radiofrequency ablation of idiopathic RVOT-VAs using contact force catheters are better or non inferior than non-contact force catheters.[Chinese Journal of Cardiac Pacing and Electrophysiology,2019,33(4):320-324]
作者
蒋靖波
李金轶
文伟明
钟国强
何燕
蒋智渊
王安
JIANG Jing-bo;LI Jin-yi;WEN Wei-ming;ZHONG Guoqiang;HE Yan;JIANG Zhi-yuan;WANG An(Department of Cardiology,Guilin People′s Hospital,Guilin541002,Guangxi,China;Department of Cardiology,The First Affiliated Hospital of Guangxi Medical University,Nanning530021,Guangxi,China)
出处
《中国心脏起搏与心电生理杂志》
2019年第4期320-324,共5页
Chinese Journal of Cardiac Pacing and Electrophysiology
基金
广西重大研发专项(桂科AB16380231)