磁导航指导与手控导管消融流出道室性早搏的对照研究  

Remote magnetic navigation vs.manual navigation for catheter ablation of outflow tract premature ventricular contractions

作　　者：苑洪涛[1] 张玉霄[1] 兰凯[1] 彭利[1] 薛桥[1] 卢才义[1] 

机构地区：[1]中国人民解放军总医院心血管内科,北京100853

出　　处：《中国循证心血管医学杂志》2017年第5期566-568,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：北京市科委"提高心血管疾病预防和治疗水平技术"推广专项课题(HXKTLUCAIYI1002)

摘　　要：目的比较第三代磁导航系统(MNS)指导导管消融与常规手控导管消融流出道室早的疗效与安全性。方法选自2014年10月~2017年1月间于中国人民解放军总医院心血管内科住院经心电图及心内电生理检查,诊断为流出道室早,随机分为磁导航指导导管消融组(33例)及手控导管消融组(35例),分析比较两组患者手术疗效、安全性及其他相关临床数据。结果两组患者基线资料无差别,磁导航组即刻成功率93.9%(31/33),手控导管组即刻成功率91.4%(32/35),两组间无显著差异(P>0.05)。两组围术期均无严重并发症发生。两组平均手术时间分别为(125±45)min vs.(105±40)min,P>0.05。平均放电时间为(270±60)s vs.(240±55)s,P>0.05。平均放电功率为(40±10)W vs.(25±5)W,P<0.05。总X线曝光时间为(1.2±0.5)min vs.(3.2±1.2)min,P<0.05。结论应用MNS系统可安全有效的用于流出道室早的标测和消融,并可有效减少X线曝光时间,消融功率较常规方法有所增加。Objective To investigate the efficacy and safety of mapping and ablating premature ventricular contractions （PVCs） originated from ventricular outflow tract using remote magnetic navigation system （MNS, Niobe ⅡI, Stereotaxis） vs. manual navigation. Methods 68 consecutive patients diagnosed as outflow tract PVCs from Oct 2014 to Jan 2017 were enrolled in our study, the mean age was 43±13 years and 38±12 years in MNS group and manual group, respectively. Mapping and ablating were performed by MNS or CARTO 3 system. The operative efficacy, safety and other relevant clinical data were compared between the two groups. Results There was no significant difference between two groups according to clinic profiles. The acute success rate was 93.9% （31/33） vs. 91.4% （32/35） （P〉0.05）, respectively. Total procedure time and ablation time was （125±45 min vs. 105±40 min, P〉0.05）, and （270±60 s vs. 240±55 s, P〉0.05）, respectively. The power was much higher in MNS group than that in manual group （40±10 W vs. 25±5 W, P〈0.05）. MNS group had less fluoroscopic time than manual group （1.2±0.5 min vs. 3.2±1.2 min, P〈0.05）. Both groups had no severe complications. Conclusion The Niobe ⅡI remote magnetic navigation system for mapping and ablation of outflow tract PVCs is effective and safe. Furthermore, it may reduce the exposure time from radiation for both patients and physicians. But higher power maybe needed.

关 键 词：磁导航 导管消融 流出道 室性早搏 

分 类 号：R540.46[医药卫生—心血管疾病]