希氏束旁旁道CARTO3在常规X光指导下标测及射频消融  

Mapping and radiofrequency ablation of para-His bundle atrioventricular accessory pathways guided by CARTO3 system or routine X-ray

作　　者：刘建国[1] 许爱斌[1] 吴龙梅[2] 谭琛[1] 李俊峡[1] 崔俊玉[1] 

机构地区：[1]北京军区总医院心血管内科,北京100700 [2]河北医科大学研究生院

出　　处：《中国循证心血管医学杂志》2014年第3期333-335,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的比较希氏束旁道CARTO3及常规X光指导下标测及消融方法。方法纳入12例希氏束旁道并进行射频消融治疗的患者。入选患者均进行了心内电生理检查,9例患者行常规X光透视下标测消融靶点并进行消融,3例患者应用CARTO3三维标测系统指导靶点标测及射频消融。对不同标测方法手术成功率、X线曝光时间及并发症进行比较。结果 9例常规标X光测患者中成功6例(66.7%),2例未成功,1例靶点距离希氏束过近,放弃消融,术中1例患者出现一过性完全性房室传导阻滞,X线曝光时间(36.2±13.4)min;CARTO3指导3例均成功(100.0%),X线曝光时间(14.2±7.8)min。与常规X光测患者比较,CARTO3三维标测系统指导靶点消融成功率更高,X线曝光时间更短,差异有统计学意义(P<0.05)。结论与常规X光相比,CARTO3指导希氏束旁旁道消融可更精确指示希氏束及消融导管空间位置,缩短X光曝光时间,提高消融成功率。Objective To compare mapping and radiofrequency ablation （RFA） of para-His bundle atrioventricular accessory pathways guided by CARTO3 system or routine X-ray. Methods The patients （n=12） with para-His bundle atrioventricular accessory pathways treated with RFA were chosen and given intracardiac electrophysiological examinations. The target of RFA was mapped with routine X-ray in 9 patients and with CARTO3 system in 3 ones, and then all patients were given treatment of RFA. The success rate of RFA, time of X-ray exposure and complications were compared between 2 methods. Results Among 9 patients with routine X-ray mapping, 6 had successful RFA （66.7%）, 2 had unsuccessful RFA and 1 abandoned RFA because of target being too near to para-His bundle atrioventricular accessory pathways. There was 1 patient had complete atrioventricular block during RFA, and the time of X-ray exposure was （36.2±13.4） min. All 3 patients with CARTO3 system mapping had successful RFA （100.0%） and the time of X-ray exposure was （14.2±7.8） min. Compared with routine X-ray mapping, CARTO3 system mapping had higher success rate and shorter time of X-ray exposure （P〈0.05）. Conclusion Compared with routine X-ray, CARTO3 system can more accurately indicate the spatial locations of para-His bundle atrioventricular accessory pathways and ablation catheter, shorten time of X-ray exposure, and improve success rate of RFA.

关 键 词：房室旁道 希氏束 射频消融 

分 类 号：R541.71[医药卫生—心血管疾病]