心房扑动不同标测方式射频导管消融的临床研究  

Clinical Investigation of Atrial Flutter Ablation Guided by Different Mapping System

作　　者：何燕[1] 钟国强[1] 曾志羽[1] 朱立光[1] 李金轶[1] 李薇[1] 凌云[1] 

机构地区：[1]广西医科大学第一附属医院心内科,530000

出　　处：《心电学杂志》2009年第4期230-234,共5页Journal of Electrocardiology(China)

基　　金：基金项目：广西科学研究与技术开发计划项目（桂科攻059207-1D）

摘　　要：目的比较普通电极、Halo电极及Carto系统标测在心房扑动射频导管消融（下称消融）中的应用。方法22例心房扑动患者分别在4极电极标测（A组，n=8）、Halo电极标测（B组，n=10）和Carto系统标测（C组，n=4）下行消融术。比较3种标测方式下消融的即时成功率、手术时间、曝光时间和放电时间。结果3组即时成功率均为100％。手术时间A组（171．9±25．6）min。B组（124±24．3）min，C组（248．6＋21．8）min；曝光时间A组（70．9±125）min，B组（527±146）min，C组（33．3±75）min；消融时间A组（701±85）s，B组（562±49）s，C组（521±56）s。3组差异均有显著性意义（P〈0.05）。随访4～12个月，A组复发2例，分别为非典型心房扑动和典型心房扑动，B组复发1例，为非典型心房扑动，C组无复发。3例复发病例均经Carto系统治疗成功，随访12月无复发。结论3种标测方式在典型心房扑动消融治疗中疗效确切，Carto系统对于治疗非典型心房扑动及复发心房扑动效果确切，且可明显减少X线曝光时间与消融时间。Objective To evaluate application of different mapping methods in radiofrequency ablation of atrial flutter （AF）. Methods 22 patients with AF underwent ablation guided by quadripolar electrode catheter （8 cases, group A）, Halo catheter （ 10 cases, group B ） or Carto system（ 4 cases, group C ） mapping, respectively. The success rate, procedure time, radiation exposure time and delivery time were compared between groups. Results The primary success rate was 100% in every group. The procedure time was （ 171.9 ± 25.6）min, （ 124 ± 24.3）min and （248.6 ± 21.8）min, the radiation exposure time （70.9 ± 12.5 ）min, （52.7 ± 14.6）min and （33.3 ± 7.5）min, and the delivery time （ 701 ± 85 ）s, （ 562 ± 49 ）s and （521 ± 56）s, in group A, B and C, respectively. There was significantly different between groups （all P 〈 0.05）. During a follow-up of 4-12 months, AF recurred in 2 cases in group A and one in group B. The 3 cases, two with atypical AF and one with typical AF, underwent successful ablation guided by Carto system mapping and had no relapse at 12-month follow-up. Conclusion The 3 mapping methods are reliable in guiding ablation of typical AF. Carto system is of benefit to ablation of atypical and recurred AF and obviously reduces radiation exposure time and delivery time.

关 键 词：心房扑动 标测系统 射频导管消融 

分 类 号：R540.41[医药卫生—心血管疾病] R540.46[医药卫生—内科学]