可控弯鞘在右侧旁道消融中的应用研究  

A clinical study of right atrioventricular bypass radiofrequency ablation using steerable sheath

作　　者：张国瑞[1] 王靖 胡继强[3] 张静[1] 华伟 张澍 楚建民 Zhang guorui;Wang jing;Hu jiqiang;Zhang jing;Hua wei;Zhang shu;Chu jianmin(Department of Cardiology,The third hospital of ShiJiaZhuang.Shijiazhuang,050011,China.;Department of Cardiology,Cardiovascular Institute and Fu Wai Hospital,CAMS and PUMC,Beijing,100037,China;Department of Cardiology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing,100078,China)

机构地区：[1]石家庄市第三医院,050011 [2]中国医学科学院阜外医院,100037 [3]北京中医药大学东方医院,100078

出　　处：《临床心电学杂志》2020年第4期285-288,共4页Journal of Clinical Electrocardiology

摘　　要：目的评价双向可控弯鞘管在右侧旁道射频消融术中应用的安全性及有效性。方法研究纳入右侧旁道伴室上性心动过速患者40例,随机分为双向可控弯鞘管组(Agilis鞘,A组)及常规固定弯鞘管组(Swartz鞘,B组)行右侧旁道射频消融术。比较两组的消融放电时间、放射时间、射线曝光量、总手术时间、成功率、复发率和并发症等。结果 A组成功率为100%,B组成功率为95%,两组比较无统计学差异(p>0.05)。与常规固定弯鞘管组相比,双向可控弯鞘管组平均放电消融时间、放射曝光时间及手术操作时间显著缩短(p<0.05);A组平均X线曝光剂量较B组显著减少(p<0.05)。两组消融过程均无严重并发症发生。随访6-12个月,两组患者均无复发。结论与常规固定弯鞘管相比,双向可控弯鞘可显著缩短射频消融时间、X线放射时间及总手术时间,减少X线曝光量,提高手术成功率且安全性良好。Objective To evaluate the safety and efficacy of steerable sheath in right atrioventricular bypass radiofrequency ablation. Methods The study enrolled 40 patients with right atrioventricular bypass and supraventricular tachycardia which were randomly divided into two groups: steerable sheath Group(Agilis TM sheath,Group A) or non-steerable sheath(Swartz TM sheath, Group B) for right bypass radiofrequency ablation. The ablation time, radiation time, radiation exposure, total operation time, success rate, recurrence rate and complications were compared between the two groups. Results Success rates of both groups showed no significant difference(100% vs.95%, p>0.0.05). Compared with non-steerable sheath group, the average ablation time, radiation exposure time and operation time of the steerable sheath group were significantly shortened, and the differences were statistically significant(p<0.05). The average X-ray radiation exposure dose of Group A was significantly lower than that of Group B, and the difference was also statistically significant(p<0.05). No serious complications occurred in both two groups.The patients were followed up for 6-12 months. Conclusions Compared with non-steerable sheath, using bidirectional steerable long sheath can significantly shorten the radiofrequency ablation time, X-ray radiation time and total operation time, reduce the X-ray exposure, improve the success rate of ablation and safety.

关 键 词：双向可控导管鞘 常规固定弯鞘管 右侧旁道 射频消融 

分 类 号：R541.7[医药卫生—心血管疾病]