Carto3系统引导压力导管射频消融术治疗阵发性房室结折返性心动过速28例

发布时间：2018-06-13 08:38

本文选题：阵发性室上性心动过速 + 阵发性房室结折返性心动过速　；参考：《山东医药》2017年15期

【摘要】：目的观察Carto3三维电解剖标测系统(后简称Carto3系统)引导压力导管射频消融术治疗阵发性房室结折返性心动过速(AVNRT)的效果。方法因AVNRT行射频消融术治疗的患者58例,观察组28例,在Carto3系统引导下采用压力导管消融术治疗;对照组30例在X线引导下行常规射频消融术治疗。记录并比较两组的消融功率、消融次数、手术成功率、手术时间、X线曝光时间、射线剂量、AVNRT复发及并发症发生情况。结果两组手术成功率均为100%。观察组消融功率为(25.7±6.0)W、放电次数(4.8±1.1)次、手术时间(86.7±11.9)min,对照组分别为(35.7±10.0)W、(7.9±3.2)次、(93.2±11.3)min,观察组消融功率和放电次数均小于对照组(P均0.01)。观察组整个手术过程零射线,对照组X线曝光时间为(23.1±6.0)min,射线剂量为(5.0±7.9)Gy/cm2,两组相比,P均0.05。随访3~6个月,两组均无复发。观察组无并发症发生,对照组发生一过性Ⅲ度房室传导阻滞3例,两组并发症发生率相比,P0.05。结论与常规射频消融术相比,Carto3系统引导下压力导管消融术消融功率更低、消融次数减少、不延长手术时间,治疗AVNRT安全、有效,还可避免X线带来的危害。
[Abstract]:Objective to observe the effect of radiofrequency catheter ablation guided by Carto3 system in the treatment of paroxysmal atrioventricular nodal reentrant tachycardia (AVNRTT). Methods Fifty-eight patients with AVNRT underwent radiofrequency ablation, 28 patients in the observation group were treated with pressure catheter ablation under the guidance of Carto3 system, and 30 patients in the control group were treated with conventional radiofrequency ablation under X-ray guidance. The ablation power, the number of ablation, the successful rate of operation, the time of X-ray exposure, the recurrence of AVNRT and the incidence of complications were recorded and compared between the two groups. Results the successful rate of operation was 100 and 100 in both groups. The ablation power was 25.7 卤6.0W, the discharge times were 4.8 卤1.1 times, the operation time was 86.7 卤11.9min in the observation group and the control group was 35.7 卤10.0W (7.9 卤3.2min). The ablation power and the discharge times in the observation group were lower than those in the control group (P < 0.01). In the observation group, the X-ray exposure time was 23.1 卤6.0 min, and the radiation dose was 5.0 卤7.9 Gy / cm ~ 2. The two groups were compared with each other (P < 0.05). Follow-up for 3 ~ 6 months showed no recurrence in both groups. There were no complications in the observation group and 3 cases in the control group with transient third degree atrioventricular block. The incidence of complications in the two groups was higher than that in the control group (P 0.05). Conclusion compared with conventional radiofrequency ablation, Carto3 system guided pressure catheter ablation has lower ablation power, less ablation times, does not prolong the operation time, is safe and effective in the treatment of AVNRT, and can avoid the harm caused by X-ray.
【作者单位】：南方医科大学南方医院;
【基金】：广东省科技计划项目(2013B021800140) 广州市科技计划项目(201300000146)
【分类号】：R541.71

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