应用重叠参考图像透视技术易化环肺静脉电隔离术操作治疗阵发性心房颤动  

Circumferential pulmonary vein isolation guided by overlay ref for the treatment of paroxysmal atrial fibrillation

作　　者：唐恺[1] 肖彬[2] 赵冬冬[1] 张敬莹[1] 陈艳清[1] 徐亚伟[1] 

机构地区：[1]同济大学附属第十人民医院心内科,上海200072 [2]浙江建德市第一人民医院心脏科

出　　处：《中华心律失常学杂志》2012年第2期107-110,共4页Chinese Journal of Cardiac Arrhythmias

基　　金：基金项目：国家自然科学基金（编号81070152）

摘　　要：目的探讨重叠参考图像透视技术（OverlayRef）对环肺静脉电隔离术治疗阵发性心房颤动（房颤）的影响。方法人选194例阵发性房颤患者，随机分为OvedayRef组（97例）及对照组（97例）。OverlayRef组使用OverlayRef技术（将参考图像以反白的形式叠加于透视屏上）辅助环肺静脉电隔离术的操作。对照组常规方法完成环肺静脉电隔离术。比较两组的总消融手术时间、消融时间、X线曝光量、肺静脉隔离率及随访1年的成功率。结果两组患者的基线临床特征差异无统计学意义。所有患者均接受了环肺静脉电隔离术。OverlayRef组的消融时间[（89±13）min对（102±22）min，P〈0．01]和总消融术时间[（139±22）min对（162±31）min，P〈0．01]均明显比对照组短。OverlayRef组的x线曝光量[（13531±283）mGy对（13123±369）mGy]稍大，但差异无统计学意义（P〉0．05）。两组的环肺静脉电隔离率（97．9％对96．9％，P=NS）及随访1年的成功率（84．5％对81．4％，P〉0．05）差异也无统计学意义。结论OverlayRef技术可以易化环肺静脉电隔离术的操作，缩短房颤导管消融术的学习曲线。Objective Circumferential pulmonary vein isolation（CPVI） is still not a easy task to an in- experienced operator for the treatment of paroxysmal atrial fibrillation（PAF）. We hypothesized that Overlay Ref technique could facilitate the procedure of CPVI. This study was to report the results of CPVI guided by Overlay Ref for the treatment of PAF. Methods One hundred and ninety-four patents suffered PAF were enrolled into this study, and randomly assigned to Overlay Ref group （ n = 97 ） and control group （ n = 97 ）. CPVI procedure was guided by inverted and faded overlay reference imaging in the Overlay Ref group and conventional approach in the control group. The total procedure time, duration of ablation, successful rate of isolation of pulmonary veins（PVs）, radiation dose as well as results of follow up in 12 months were recorded. Results All patients were successfully to undergo CPVI procedure. Duration of ablation procedure in the Overlay Ref group was sig- nificantly shorter than that in the control group（89±13 min versus 102±22 min, P〈0. 01 ）. This led to a shorter total procedure time in the Overlay Ref group（ 139±22 min versus 162±31 min, P〈0.01 ）. The radiation dose seemed a little more in the Overlay Ref group. However, it was no statistical difference in these two groups （13531±283 mGy versus 13123±369 mGy, P〉0. 05）. The successful rate of isolation of PVs was similar in both groups（97. 9% versus 96. 9, P=NS）. As far as the successful rate of follow up in 12 months was con- cerned, it was also no significantly difference in these two groups （84. 5 % versus 81.4, P〉O. 05 ）. Conclusion Overlay Ref technique could facilitate the CPVI procedure, might shorten the learning curve to inexperienced operators for catheter ablation of PAF.

关 键 词：环肺静脉电隔离术 重叠参考图像透视技术 电解剖标测 心房颤动 

分 类 号：R541.75[医药卫生—心血管疾病]