弯型可视双向可调弯鞘管与固定弯鞘管在阵发性心房颤动射频消融中的对照研究  

A controlled study of curved visual bidirectional adjustable bent sheath canal versus fixed bent sheath canal in radiofrequency ablation of paroxysmal atrial fibrillation

作　　者：刘丽云 夏雨 孟旭 刘尚雨 吴灵敏 郑黎晖 甘丰[1] 丁立刚 姚焰 LIU Li-yun;XIA Yu;MENG Xu;LIU Shang-yu;WU Ling-min;ZHENG Li-hui;GAN Feng;DING Li-gang;YAO Yan(Cardiovascular Medicine,Beijing Aerospace General Hospital,Beijing 100076,China;Arrhythmia Center,National Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China)

机构地区：[1]北京航天总医院心内科,北京100076 [2]中国医学科学院阜外医院国家心血管病中心心律失常中心

出　　处：《中国心血管病研究》2023年第8期704-709,共6页Chinese Journal of Cardiovascular Research

基　　金：阜外医院横向课题(T2023-ZX015)。

摘　　要：目的探讨弯型可视双向可调弯鞘管与固定弯鞘管在心房颤动(房颤)导管射频消融术(RFCA)中的应用,评估弯型可视双向可调弯鞘管是否在术中具有明显的优势。方法选取中国医学科学院阜外医院2022年1月至2022年10月首次接受RFCA行环肺静脉隔离术(PVI)的49例阵发性房颤患者作为研究对象,依据应用不同类型鞘管分为两组,一组患者采用弯型可视双向可调弯鞘管,另一组患者采用固定弯鞘管。比较两组患者在PVI时长、手术总时长、导管操作时长、消融点数、每个消融点的平均放电时长、PVI单圈隔离率、碎点率、术者消融感受评分、有无并发症、术后复发率等方面的差异。结果弯型可视双向可调弯鞘管组右肺静脉隔离(RPVI)时长[(10.59±2.32)min比(14.06±6.13)min,P=0.030]、导管操作时长[(6.59±2.76)min比(13.25±6.82)min,P=0.000]均较固定弯鞘管组显著减少,弯型可视双向可调弯鞘管组术者消融感受得分高于固定弯鞘管组[(7.67±0.80)分比(6.00±0.82)分,P=0.004],碎点率低于固定弯鞘管组[(0.03±0.03)比(0.08±0.01),P=0.014],差异均具有统计学意义(P<0.05),两组间左肺静脉隔离(LPVI)时长、手术总时长、PVI单圈隔离率、消融点数、每个消融点的平均放电时长、术中并发症、术后复发率方面无统计学差异(P>0.05)。结论弯型可视双向可调弯鞘管在RFCA术中能够明显缩短RPVI时长、导管操作时长,减少射频过程的耗时,改善术者消融感受,降低碎点率,不降低单圈隔离率、不增加术中并发症发生率及术后房颤复发率。Objective To investigate the application of curved visual bidirectional adjustable bent sheath and fixed bent sheath in catheter radiofrequency ablation(RFCA)for atrial fibrillation(AF)in order to evaluate whether the curved visual bidirectional adjustable bent sheath has obvious advantages during the surgery.Methods A total of 49 patients with paroxysmal atrial fibrillation who underwent RFCA for the first time from January 2022 to October 2022 were enrolled,and all the patients were divided into two groups according to the application of different types of sheaths;one group was treated with a curved visual bidirectional adjustable bent sheath,and the other group was treated with a fixed bent sheath.The differences in PVI duration,total surgical duration,catheter operation duration,number of ablation points,average discharge time of each ablation point,PVI first pass isolation,fragmentation rate,ablation feeling score of the operator,intraoperative complications and the postoperative recurrence rate between the two groups were compared.Results The duration of right pulmonary venous isolation(RPVI)[(10.59±2.32)min vs.(14.06±6.13)min,P=0.030]and catheter operation time[(6.59±2.76)min vs.(13.25±6.82)min,P=0.000]in the curved visual bidirectional adjustable bent sheath tube group were significantly reduced compared with the fixed bent sheath group;the ablation feeling score of the operator in the curved visual bidirectional adjustable bent sheath group was higher than that in the fixed bent sheath group(7.67±0.80,6.00±0.82,P=0.004);the fragmentation rate was lower than that in the fixed bent sheath group(0.03±0.03,0.08±0.01,P=0.014);and the differences were statistically significant(P<0.05).There were no significant differences in the left pulmonary venous isolation(LPVI),total surgical time,PVI first pass isolation,number of ablation points,average discharge time of each ablation point,intraoperative complications and postoperative recurrence rate between the two groups(P>0.05).Conclusion Curved visual bidi

关 键 词：弯型可视双向可调弯鞘管 阵发性心房颤动 肺静脉隔离术 导管消融 

分 类 号：R541.7[医药卫生—心血管疾病]