Visitag联合FTI技术在房颤肺静脉前庭电隔离术中的应用  

Application of Visitag combined with pressure-time integral in pulmonary vein antrum isolation for atrial fibrillation

作　　者：周远林[1] 张文勇[1] 刘剑雄[1] 胡咏梅[1] ZHOU Yuan-lin;ZHANG Wen-yong;LIU Jian-xiong;HU Yong-mei(Department of Cardiology, Chengdu Second People's Hospital, Chengdu 610017, Sichuan, CHINA)

机构地区：[1]成都市第二人民医院心内科,四川成都610017

出　　处：《海南医学》2018年第23期3292-3295,共4页Hainan Medical Journal

摘　　要：目的观察Visitag联合接触压力-时间积分(FTI)技术在心房颤动肺静脉前庭电隔离术中的临床疗效,探讨肺静脉前庭前壁、顶部FTI值设为450～500 g·s,后壁、底部FTI值设为400～450 g·s的有效性及安全性。方法入选2016年1月至2017年2月在成都市第二人民医院心内科行导管消融术的心房颤动患者120例,按手术顺序分为研究组(使用ST压力导管在Visitag技术指导下逐点消融,60例)和对照组(使用ST压力导管拖动消融,60例),记录环肺静脉不同区域达到设定FTI值所需压力及消融时间、肺静脉单圈隔离率、肺静脉-左房传导恢复率、肺静脉前庭隔离时间、肺静脉前庭X线曝光时间、术中并发症和1年复发率。结果两组患者术中肺静脉前庭隔离率均达100%,研究组肺静脉前庭单圈隔离率达76.6%,肺静脉-左房传导恢复率为5.0%,均优于对照组(单圈隔离率26.6%,传导恢复率20.0%),差异均有统计学意义(P<0.05);研究组和对照组患者在前庭单圈隔离时间[(70.4±12.8) min vs (54.2±10.6) min),前庭总隔离时间[(73.8±10.4) min vs (78.3±14.4) min],肺静脉前庭隔离时所用X线曝光时间[(2.8±0.9) min vs (4.1±1.6) min]比较差异均无统计学意义(P>0.05);两组患者术中均无心包积液、血栓栓塞、大出血等导管操作并发症。随访1年研究组和对照组患者的复发率分别为26.7%、21.7%,差异无统计学意义(P>0.05)。结论肺静脉前庭前壁、顶部FTI值设为450～500 g·s,后壁、底部FTI值设为400～450 g·s是安全有效的;可以提高肺静脉前庭的单圈隔离率,降低肺静脉-左房传导恢复率。Objective To observe the clinical efficacy of Visitag combined with pressure-time integral (FTI) technique in pulmonary vein antrum isolation for atrial fibrillation, and to investigate the efficacy and safety with the anterior wall and top FTI value set to 450-500 g·s and the posterior wall and bottom FTI values set to 400-450 g·s. Methods A total of 120 patients with atrial fibrillation undergoing catheter ablation in the Department of Cardiology, Second People's Hospital of Chengdu from January 2016 to February 2017 were selected and divided into study group (point-by-point ablation under the guidance of Visitag and ST pressure catheter, n=60) and control group (drag ablation using ST pressure catheter, n=60) according to the surgical procedure. The pressure and ablation time required to reach the FTI set value in different areas of the pulmonary vein, unilateral isolation rate of the vestibule, recovery rate of pulmonary vein-left atrium conduction, unilateral isolation time of vestibule, and the X-ray exposure time for pulmonary vein isolation, intraoperative complications, 1-year recurrence rate were recorded. Results All pulmonary veins were isolated in both groups (100%). The unilateral isolation rate of the vestibule was 76.6%, and the recovery rate of pulmonary vein-left atrium conduction was 5.0% in the study group, significantly better than 26.6%, 20.0% in the control group (P<0.05). There was no statistically significant difference between the two groups (P>0.05) in unilateral isolation time of vestibule (70.4±12.8) min vs (54.2±10.6) min, total isolation time of vestibule (73.8±10.4) min vs (78.3±14.4) min, the X-ray exposure time for pulmonary vein isolation (2.8±0.9) min vs (4.1±1.6) min. There were no catheter complications such as pericardial effusion, thromboembolism, and hemorrhage in both groups. The recurrence rate was similar between the two groups at the 1-year follow-up (26.7% vs 21.7%, P>0.05). Conclusion Pulmonary vein antrum isolation is safe and effective with the anterior wal

关 键 词：心房颤动 肺静脉前庭电隔离 接触压力-时间积分 导管消融 

分 类 号：R541.75[医药卫生—心血管疾病]