CARTO3系统三维电解剖标测指导阵发性室上性心动过速导管消融的初步研究  

Preliminary study on catheter ablation of paroxysmal supraventricular tachycardia guided by CARTO3 electroanatomical navigation system

作　　者：崔海明[1] 张家友[1] 廖德宁[1] 

机构地区：[1]第二军医大学附属长征医院心内科,上海200003

出　　处：《中国心脏起搏与心电生理杂志》2014年第2期115-118,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探索使用三维电解剖指导阵发性室上性心动过速(PSVT)射频消融方法的可行性及效果。方法选择连续入院行射频消融的PSVT患者共47例,分为两组,三维组使用CARTO 3三维电解剖系统指导消融(n=26),常规组使用X线指导消融(n=21),比较两组X线透视时间、X线用量等的差异。结果三维组X线透视时间明显少于二维组[(81±84)s vs(1 124±405)s,P<0.01],相应的X线用量也大为减少[(97±105)mGy vs(1628±555)mGy,P<0.01]。三维组14例房室结双径路患者中,有9例(64%)完全无X线透视。所有病例均手术成功,无明显并发症。结论三维电解剖指导PSVT射频消融是安全和有效的,可以显著减少X线透视,部分可实现完全无X线透视完成消融手术。Objective To explore the feasibility and effectiveness of catheter ablation of paroxysmal supraventficular tachycardia（PSVT） guided by CARTO 3 electroanatomical navigation system. Methods Forty-seven patients with PSVT underwent catheter ablation were divided into two groups, 3D group using CARTO 3 guide ablation （n = 26）, the conventional group using X-Ray guide ablation （n= 21 ）. X-ray fluoroscopy time, X-ray fluoroscopy exposure were compared in two groups. Results Fluoroscopy time of CARTO 3 group was less than that of X-Ray group [ （81 ±84） s vs （ 1 124 ±405 ） s, P〈0.01 ] , with a correspondingly low radiation exposure [ （ 97± 105 ） mGy vs （ 1 628 ±555 ） mGy, P〈 0.01 ] . In 9/14（64% ） atrioventricular nodal reentry tachycardia （AVNRT） cases, electroanatomical mapping avoided fluoroscopy entirely. All procedures were acutely successful , and without incurring in any major complication. Con- clusion Using 3 D electroanatomical navigation system （ CARTO 3 system） in supraventrieular arrhythmia ablation is ef- fective and safe,it can markedly reduce fluoroscopy exposure. In many cases, non-fluoroscopic RFCA is feasible.

关 键 词：心脏病学 阵发性室上性心动过速 导管消融 射频电流 电解剖标测 x线 

分 类 号：R541.71[医药卫生—心血管疾病] R454.1[医药卫生—内科学]