三维电生理技术在房室结改良术中的应用价值  

Application of three-dimensional electrophysiologic technique in atrioventricular node modification

作　　者：冯倩倩 楚英杰 董淑娟 李静超 余海佳 宋慧慧 FENG Qianqian;CHU Yingjie;DONG Shujuan;LI Jingchao;YU Haijia;SONG Huihui(Department of Cardiology,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou450003,China)

机构地区：[1]郑州大学人民医院河南省人民医院心内科,郑州450003

出　　处：《中华实用诊断与治疗杂志》2020年第4期363-365,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省卫生厅重点科技攻关项目(122102310068)。

摘　　要：目的观察三维电生理技术在治疗房室结折返性心动过速(atrioventricular node recurrent tachycardia,AVNRT)中的效果,探讨其在房室结改良术中的应用价值。方法将60例AVNRT患者随机分为三维组和二维组,每组各30例。三维组在Carto-3系统指导下进行射频消融,二维组在X线透视下进行射频消融。比较2组总手术时间、消融前准备时间、消融导管操作时间、放电次数、放电时间、消融无结区反应发生率、不良结区反应发生率、有效消融未达手术终点发生率、X线曝光时间、X线曝光剂量、手术成功率及房室传导阻滞发生率。结果三维组总手术时间[(58.20±8.00)min]、消融导管操作时间[(19.27±6.78)min]及放电时间[(5.30±1.30)min]短于二维组[(66.40±7.00)、(27.60±6.13)、(7.40±1.80)min](P<0.05),放电次数[(7.90±3.30)次]、X线曝光时间[(1.40±1.20)min]、X线曝光剂量[(5.90±3.60)mGy]少于二维组[(12.20±3.80)次、(4.00±2.00)min、(17.90±8.80)mGy](P<0.05),消融前准备时间[(19.47±5.04)min]、消融无结区反应发生率(43.3%)、不良结区反应发生率(10.0%)、有效消融未达手术终点的发生率(16.7%)与二维组(19.27±4.73)min、66.7%、20.0%、33.3%比较差异均无统计学意义(P>0.05),2组手术成功率均为100%,术后均无房室传导阻滞发生。结论三维电生理技术应用于房室结改良术中,可有效减少消融导管操作时间、放电次数、放电时间、X线曝光时间及剂量,使射频消融更具准确性、安全性和有效性。Objective To investigate the efficacy of three-dimensional electrophysiologic technique on atrioventricular node recurrent tachycardia(AVNRT)and its value to the atrioventricular node modification.Methods Sixty patients with AVNRT were randomly divided into three-dimensional group and two-dimensional group,with 30 patients in each group.Three-dimensional group was performed radiofrequency ablation under the guidance of Carto-3 system,and two-dimensional group was performed radiofrequency ablation under X-ray fluoroscopy.The total operation lasting time,preparation time before ablation,catheter operation time,discharge frequency,discharge time,incidence of ablation-free zone reaction rate,incidence of adverse zone reaction rate,incidence of effective ablation not reaching the end point of operation,X-ray exposure time,X-ray exposure dose,surgical success rate and incidence of atrioventricular block were compared between two groups.Results The total operation lasting time((58.2±8.0)min),ablation catheter operation time((19.27±6.78)min),discharge time((5.30±1.30)min)and X-ray exposure time((1.40±1.20)min)in three-dimensional group were shorter than those in two-dimensional group((66.40±7.00),(27.60±6.13),(7.40±1.80)min,(4.00±2.00)min)(P<0.05).The discharge frequency(7.90±3.30),and X-ray exposure dose((5.90±3.60)mGy)were less in three-dimensional group than those in two-dimensional group(12.20±3.80,(17.90±8.80)mGy)(P<0.05).The preparation time before ablation((19.47±5.04)min vs.(19.27±4.73)min),incidence of ablation-free zone reaction rate(43.3%vs.66.7%),incidence of adverse zone reaction rate(10.0%vs.20.0%),incidence of effective ablation not reaching the end point of operation(16.7%vs.33.3%)and surgical success rate(100%vs.100%)showed no significant differences between three-and two-dimensional groups(P>0.05).No atrioventricular block occurred after operation.Conclusion Three-dimensional electrophysiologic technique can effectively shorten the operation time,discharge time and exposure time,and reduce

关 键 词：房室结折返性心动过速 导管射频消融 三维电生理技术 二维电生理技术 房室结改良术 

分 类 号：R541.7[医药卫生—心血管疾病]