Ensite NavX^(TM)指导下“零射线”射频消融室上性心动过速  

Radiofrequency ablation of supraventricular tachycardia without X-ray radiation under the guidance of Ensite NavX^(TM) mapping system

作　　者：林涛 魏欣[2] 徐晓薇[2] 刘腾飞 关付 李广平 Lin Tao;Wei Xin;Xu Xiaowei;Liu Tengfei;Guan Fu;Li Guangping(Department of Cardiology,the second Hospital of Tinnjn Medical University,Tianjin 300211,China;Department of Cardiology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Cardiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]天津医特大学第二医院心内科,300211 [2]首都医科大学附属北京天坛医院心内科,100070 [3]首都医科大学附属北京世纪坛医院心内科,100038

出　　处：《中国心血管杂志》2021年第6期555-559,共5页Chinese Journal of Cardiovascular Medicine

基　　金：国家自然基金面上项目(81570304)。

摘　　要：目的评估应用电生理三维标测系统(Ensite NavX^(TM))作为导管可视化和定位指导下完成射频导管消融(RFCA)治疗室上性心动过速(SVT)的可行性和安全性。方法对53例SVT患者进行电生理检查和RFCA,手术均完全在Ensite NavX^(TM)系统引导下完成(36例房室结折返心动过速,12例房室旁道、3例典型心心房扑动动、2例右房房性心动过速)。随访24个月,观察预后情况。结果所有53例均完全在Ensite NavX^(TM)三维解剖标测指导下完成手术,完全避免了X线透视。其中8例左侧房室旁道消融导管通过主动脉逆行入路进入左心腔完成标测和消融。其余45例(84.9%)均为右心相关心律失常,经股静脉入路完成手术。平均手术时间为(103±27)min。1例房室结双径路患者术中发生短暂Ⅲ度房室传导阻滞,术后恢复为Ⅰ度房室传导阻滞。随访24个月,无手术相关并发症,未复发室上性心动过速。结论在Ensite NavX^(TM)系统指导下进行非透视RFCA治疗SVT具有较好的安全性和有效性。Objective To explore the feasibility and safety of radiofrequency catheter ablation(RFCA)for the treatment of supraventricular tachycardia(SVT)without X-ray radiation under the guidance of Ensite NavX^(TM) mapping system.Methods Electrophysiological examination and RFCA were performed on 53 SVT patients,and RFCA(36 atrioventricular nodal reentry tachycardia,12 atrioventricular reentry tachycardia,3 typical atrial flutter,and 2 right atrial tachycardia)were completed under the guidance of Ensite NavX^(TM) mapping system.Results All 53 cases received successful RFCA,and X-ray fluoroscopy was completely avoided.Among them,8 cases of the left atrioventricular accessory pathway were finished mapping and ablation procedure through the retrograde aortic approach.Another 45 cases(84.9%)were related to right ventricular related arrhythmia,the operation was completed through femoral vein approach.The average operation time was(103±27)min.One case of complete atrioventricular block(AVB)occurred in a short period during the operation,and recovered toⅠ°AVB after the operation.During the follow-up period of 24 months,there was no other complications and no recurrence of SVT.Conclusions Non-fluoroscopy RFCA treatment is safe and effective for SVT under the guidance of Ensite NavX^(TM) mapping system and without X-ray radiation.

关 键 词：室上性心动过速 三维标测系统 射频消融 

分 类 号：R541.71[医药卫生—心血管疾病]