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的应用

发布时间：2018-11-21 14:31

【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(P0.05),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。
[Abstract]:Objective: to investigate the safety and effectiveness of CARTO 3D mapping system combined with two modeling methods in radiofrequency ablation of paroxysmal atrial fibrillation (paroxysmal atrial fibrillation). Methods: one hundred and fifty patients with paroxysmal atrial fibrillation treated by radiofrequency ablation were randomly divided into three groups: group A (n = 50): conventional point-to-point modeling guided annular pulmonary vein isolation for atrial fibrillation; Group B (nm50): the model of left atrium and pulmonary vein was constructed by rapid anatomic modeling as the guide for ablation of circumferential pulmonary vein, and group C (nm50): the model of left atrium was constructed by point-to-point mapping. The vestibule of annular pulmonary vein was constructed by rapid anatomical mapping after the orifice of pulmonary vein was fixed, and then radiofrequency ablation of atrial fibrillation was performed after confirming the accuracy of fixed orifice. The other procedures and methods were the same in the three groups. The operative time, X-ray exposure time, success rate and incidence of complications were recorded in the three groups. Left atrial size and left ventricular systolic function were measured by echocardiography before and 6 months after operation. Results: the operative time and X-ray exposure time in group C were significantly lower than those in group A (P0.05). The success rate of group), C was slightly higher than that of group A and group B, but the difference was not statistically significant. No serious complications occurred in all three groups. Echocardiography showed no significant changes in left atrial size and left ventricular ejection fraction 6 months after operation. Conclusion: the combination of two modeling methods of CARTO and radiofrequency ablation for atrial fibrillation is safe and effective, which can reduce the operative time and X-ray exposure time, and improve the accuracy of circumferential pulmonary vein orifice. It has certain guiding significance for radiofrequency ablation of atrial fibrillation.
【作者单位】：贵州省人民医院心内科;重庆医科大学第二附属医院心内科;
【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])
【分类号】：R541.75

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