Carto标测下双极射频消融术治疗实验猪室壁瘤相关室性心动过速的研究  

Bipolar radiofrequency ablation guided by carto mapping to control ventricular tachycardia related to ventricular aneurysm in swine model

作　　者：刘长城[1] 顾承雄[1] 李波[1] 王粮山 王琎[2] 胡宇才[3] 于洋[1] 李琴[1] 高铭鑫[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心外科,100029 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029 [3]河南中医药大学第一附属医院心内科

出　　处：《心肺血管病杂志》2016年第11期892-895,905,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金(81370436);北京市教育委员会科技计划面上项目(11520107);北京市教委项目(KZ201410025028)

摘　　要：目的：探索Carto标测指导下,双极射频消融术治疗室壁瘤相关室性心动过速的可行性。方法：14头实验猪利用左侧肋间小切口冠状动脉缝扎法建立猪急性心肌梗死（AMI）模型。建模6~8周后对左心室造影证实有室壁瘤的模型猪诱发持续室性心动过速（VT）。将可诱发VT的模型猪随机分为射频组和对照组。射频组行基质标测,解剖定位缓慢传导区,然后进行双极射频消融术（BRF）。BRF后,两组模型猪再次诱发VT。评价BRF的可行性。结果：14头猪建模6~8周后存活10头,左心室造影证实8头形成室壁瘤,其中7头可诱发持续VT。射频组5头,对照组2头。射频组均成功施行了基质标测下BRF,无手术死亡。术后射频组80%模型猪VT不可诱发,而对照组100%可诱发VT（P〈0.05）。结论：Carto标测指导下BRF在室壁瘤相关VT模型的应用是可行的,即刻控制VT是有效的。Objective： To evaluate the feasibility of bipolar radiofreuency ablation（ BRF） guided by Carto mapping for treating ventricular tachycardia related to ventricular aneurysm. Methods： Fourteen swines suffered from acute myocardial infraction（ AMI） with minimally invasive ligating coronary artery via left chest.After 6-8 weeks of AMI,the survivals with left venticular aneurysm（ LVA） confirmed by ventricular angiography accepted inducing sustained ventricular tachycardia（ VT）. The swine models with VT were divided randomly to two groups（ BRF group versus control group）. Before ablation,BRF group underwent substrate mapping using Carto system to anatomically locate slow-conduction zone. VT was induced again in two groups to compare validity of BRF. Results： Ten swines were survival after 6-8 weeks of AMI. Eight of them were developed LVA,and VT were induced successfully in 7 objects and five of 7 objects in BRF group underwent surgical ablation guided by substrate mapping uneventfully. When VT induced again,80%（ 4 /5） of BRF group was not inducible.However,the rate of recurrence in control group was 100%（ 2 /2）,P 〈0. 05. Conclusion： BRF is feasible in swine model and is validity to real-time control of LVA related VT.

关 键 词：室壁瘤 室性心动过速 基质标测 双极射频消融术 动物模型 

分 类 号：R54[医药卫生—心血管疾病]