EnSite3000指导下射频消融房性心律失常的临床疗效观察  

Observation of Clinical Efficacy of EnSite3000-guided Radiofrequency Ablation for the Treatment of Atrial Arrhythmia

作　　者：魏雅娜[1] 甘继宏[1] 赵玉[1] 

机构地区：[1]兰州军区乌鲁木齐总医院心内科,新疆乌鲁木齐830000

出　　处：《医学临床研究》2011年第6期1030-1032,共3页Journal of Clinical Research

摘　　要：【目的】观察房性心律失常在EnSite3000指导下射频消融的疗效及安全性。【方法】回顾性分析2008年3月至2011年3月期间本院心内科的47例房性心律失常患者治疗状况，本组阵发性房颤26例，其中11例同时存在房早、房速和（或）房扑；永久性房颤4例；阵发及持续房扑8例（典型房扑3例）；阵发性房速9例，在EnSite3000指导下进行电生理标测，行射频消融治疗。【结果]47例患者中38例（80．9％）1次手术成功。有4例阵发性房颤术后反复发作房扑和（或）房速，其中1例术后半年再次接受射频消融治疗成功。4例永久性房颤患者术后未能维持窦性心律。16例房扑、房速患者1次消融成功，术后随访6～12wh月无复发，另1例缺血性心肌病合并房速的老年患者术后第2天因房速再次出现并诱发室颤予安置埋藏式心脏复律除颤器（ICD）。共发生3例并发症（6．38％）。【结论]EnSite3000三维标测技术可构建心脏三维模型，立体直观展示心脏结构，并直观显示心律失常起源点、激动顺序及关键部位，从而提高手术成功率及安全性。[Objective] To observe the effectiveness and safety of radiofrequency ablation g.uided by EnSite3000 for the treatment of atrial arrhythmia. [Methods] The treatment of 47 patients with atrial arrhythmia in the department of cardiology in our hospital from March 2008 to March 2011 was analyzed retrospectively. All patients included 26 paroxysmal atrial fibrillation in which 11 cases were simultaneous with atrial premature, atrial tachycardia and auricular flutter, 4 permanent atrial fibrillation, 8 paroxysmal and permanent atri alflutter（3 typical atrialflutter） and 9 paroxysmal atrialflutter. EnSite3000 guided the electrophysiological mapping. Radiofrequency ablation was performed. [Results] Among 47 cases, 38 cases（80. 9 %） underwent the operation successfully for one time. Atrialflutter and/or atrial tachycardia occurred in 4 cases with permanent atrial fibrillation after operation again and again. In the 4 cases, one case was cured by undergoing radiofrequeney ablation half a year after operation again. No sinus rhythm was found in 4 cases of permanent atrial fi brillation after operation. Sixteen cases underwent radiofrequency ablation successfully for one time. No postoperative recurrence was found during the follow up for 6-12 months. One elderly case of ischemic cardiomyopathy with atrial tachycardia occurred atrial fibrillation and received implantable cardioverter defibrillator （ICD） because of atrial tachycardia at the second day after operation. Complications were found in 3 cases（6. 38%）. [Conclusion] EnSite3000 3D mapping technology can construct the heart 3D model, and clearly and stereoscopically display the cardiac structures, and directly display the origin point, activation sequence and the key site of arrhythmia. Therefore, this technique can improve the success rate and safety of the operation.

关 键 词：心律失常/治疗 导管消融术 

分 类 号：R541.7[医药卫生—心血管疾病]