三维电解剖标测指导环肺静脉线性消融治疗阵发性心房颤动  

Circumferential linear ablation of paroxysmal atrial fibrillation guided by three-dimensional electroanatomical system

作　　者：邓金龙[1] 覃绍明[1] 林英忠[1] 韦开福[1] 覃丽萍[1] 林丽萍[1] 

机构地区：[1]广西壮族自治区人民医院心内科,南宁市530021

出　　处：《广西医学》2007年第6期802-804,F0003,共4页Guangxi Medical Journal

摘　　要：目的探讨在Carto三维电解剖标测指导左心房环肺静脉线性消融治疗阵发性心房颤动的疗效。方法对2例入选的阵发性房颤患者使用Carto系统建立左心房三维电解剖图,结合肺静脉造影确定肺静脉开口,围绕左、右上、下肺静脉口完成环肺静脉线性消融。预设温度43℃,最大功率30W,每点消融时间大于20s。局部电位振幅降低50%以上再移动靶点,逐点完成预定消融线。结果2例患者操作时间分别为181min和193min,透视时间为60min和78min,放电次数120次和136次。术后随访8个月和1个月。例2在术后第3天再发房颤,但1个月内次数较前明显减少。2例患者均无肺静脉狭窄发生。结论三维电解剖标测指导在左心房环肺静脉线性消融治疗阵发性房颤安全有效。Objective To investigate the efficacy and safety of circumferential linear ablation of paroxysmal atrial fibrillation guided by dimemional electroanatomical system（Carto）.Methods Two patients with paroxysmal atrial fibrillation were enrolled in the study. A nonfluoroscopic mapping system was used to generate a 3D electroanatomical left atrium mapping, and all pulmonary vein ostia were marked under the help of angiography on 3D mapping. Radiofrequency （RF） energy was delivered to create continuous linear lesions encircling the pulmonary veins. It was delivered with a target temperature of 43℃ ,a maximal power limit of 30 watts and applied for t〉20 seconds until the maximal local potontlal amplitude decreased by ≥50%.The ablation was completed by finishing the circular line. Results The proedure duration d the 2 cases was 181 and 193 minutes respectively,with fluoroscopy time of 60 and 78 minutes.Tne number of RF pulses was 120 and 136 respeetively. After a follow-up of 8 months,the first ease maintained sinus rhythm. The second ease was recurrent on 3rd day after the ,ahl,fion ,but suffered from less frequent atrial fibrillation during the following month. No pulmonary vein stenosis was observed. Conclusion Circumferential linear sblation of atrial fibrillation guided by three-dimensional electroanatomical system was safe and effective.

关 键 词：心房颤动 电生理学技术 环肺静脉线性消融术 

分 类 号：R541.71[医药卫生—心血管疾病]