KODEX-EPD三维标测系统在室上性心动过速射频导管消融术中应用的初步体会  

Application Experience of KODEX-EPD 3D Mapping System in Radiofrequency Ablation of Supraventricular Tachycardia

作　　者：黄俊 丁立刚[2] 李宜富 廖志勇 李腾 李华龙 梁建 阮焕钧 彭文杰 姚焰[2] HUANG Jun;DING Ligang;LI Yifu;LIAO Zhiyong;LI Teng;LI Hualong;LIANG Jian;RUAN Huanjun;PENG Wenjie;YAO Yan(Arrhythmia Center,Fuwai Hospital Chinese Academy of Medical Sciences,Shenzhen Hospital,Shenzhen(518057),Guangdong,China)

机构地区：[1]中国医学科学院阜外医院深圳医院心律失常,广东省深圳市518057 [2]中国医学科学院北京协和医学院国家心血管病中心阜外医院心律失常中心 [3]南宁市第一人民医院心血管内科

出　　处：《中国循环杂志》2022年第3期276-280,共5页Chinese Circulation Journal

摘　　要：目的:总结KODEX-EPD三维标测系统指导下行室上性心动过速射频导管消融术(RFCA)的初步体会。方法:总结分析2021年3月16日至2021年3月19日在我院接受KODEX-EPD三维标测系统指导下RFCA治疗的5例室上性心动过速患者,其中男性3例,女性2例,平均年龄(44.2±15.7)岁。记录手术过程、手术时间、X线辐射时间、X线辐射剂量、手术效果、并发症等情况。结果:5例患者中房室结折返性心动过速(AVNRT)3例,B型预激综合征(WPW)1例,房室折返性心动过速(AVRT)1例;2例外院RFCA术后复发,术中证实1例仍为AVNRT,1例为左侧旁路。平均手术时间为(42.4±9.8)min,建模时间为(5.6±3.6)min,消融显效时间为(8.2±7.2)s,X线辐射时间为(0.36±0.33)min,X线辐射量为(2.6±2.7)mGy,其中2例AVNRT患者实现零射线。消融过程中三维模型上导管移位均<1 mm,导管贴靠指示均为绿色,5例患者均消融成功,无并发症。结论:KODEX-EPD三维标测系统指导下行室上性心动过速射频导管消融术安全、有效,部分AVNRT患者可实现零射线,不增加手术时间及手术风险。Objectives: To summarize the application experience of radiofrequency catheter ablation(RFCA) for patients with supraventricular tachycardia(SVT)under the guidance of KODEX-EPD three-dimensional mapping system.Methods: The clinical data including operation process, operation time, X-ray radiation time, X-ray radiation dose,ablation effect and complications of 5 patients with SVT treated with RFCA under the guidance of KODEX-EPD threedimensional mapping system in our hospital from March 16, 2021 to March 19, 2021 were summarized and analyzed.Results: Among the 5 patients(3 males, mean age: [44.2±15.7] years), there were 3 cases of atrioventricular nodal reentrant tachycardia(AVNRT), 1 case of type B preexcitation syndrome(WPW), 1 case of atrioventricular reentrant tachycardia(AVRT). Among the 2 cases of recurrence after previous RFCA, 1 case was AVNRT and another case was left accessory pathway,which were confirmed during operation. The average operation time was(42.4 ±9.8) min, modeling time was(5.6 ±3.6) min, effective ablation time was(8.2 ±7.2) s, X-ray radiation time was(0.36 ±0.33) min, X-ray dose was(2.6±2.7) mGy. Among the 5 patients, zero radiation was achieved in 2 patients with AVNRT. During the ablation process, the displacement of the catheter on the three-dimensional model was all less than 1 mm, and the indication of catheter attachment was all green. All 5 patients were ablated successfully and there were no complications post ablation.Conclusions: Radiofrequency catheter ablation of supraventricular tachycardia under the guidance of KODEX-EPD three-dimensional mapping system is safe and effective. Zero radiation could be achieved in some patients with AVNRT without increasing the operation time and procedure risk.

关 键 词：KODEX-EPD系统 三维标测系统 室上性心动过速 射频导管消融术 

分 类 号：R541.4[医药卫生—心血管疾病]