| 摘要: |
| 目的 探索使用三维电解剖指导右室流出道室性早搏射频消融方法的可行性及效果。方法 选择连续入院行射频消融的频发室早患者共49例，分为两组，一组使用CARTO 3三维电解剖系统指导消融（三维组，n=29），一组使用常规X线指导消融（常规组，n=20）。比较两组手术时间、X线透视时间、X线用量、手术费用、并发症、成功率和复发率等差异。结果 三维组即刻成功率为100%(29/29)，常规组为95%(19/20)；常规组有3例并发症，三维组无明显并发症；随访6个月，常规组复发3例(15.0％)，三维标测组无复发。三维组X线透视时间明显少于常规组[(1.3±3.6) min vs (44.2±28.2) min,P<0.01]，相应的X线用量也大为减少[(93±242 ) mGy vs (3 919±2 309) mGy, P<0.01]，但手术费用较高(P<0.01)。两组手术总时间差异无统计学意义。三维组29例患者中，有20例（69.0%）完全无X线透视。结论 三维电解剖指导右室流出道室性早搏射频消融是安全和有效的，可以显著减少X线透视时间和X线曝光量，部分可实现完全无X线透视完成消融手术。 |
| 关键词: 心脏病学 右室流出道室性早搏 射频消融 电解剖标测 X线 |
| DOI：10.3724/SP.J.1008.2014.00910 |
| 投稿时间：2013-12-15修订日期：2014-07-03 |
| 基金项目: |
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| Catheter ablation of Idiopathic Right Ventricular Outflow Tract Premature Ventricular Contractions guided by 3D electroanatomical navigation system |
| cuihaiming,zhangjiayou,liaodening |
| (Changzheng Hospital，Second Military Medical University) |
| Abstract: |
| [Abstract[已经根据中文重新翻译]] Objective To explore the feasibility and effectiveness of catheter ablation of Idiopathic Right Ventricular Outflow Tract Premature Ventricular Contractions (RVOT-PVCs) guided by CARTO3 electroanatomical navigation system. Methods 49 patients with RVOT-PVCs underwent catheter ablation were divided into two groups, 3D group using CARTO3 guide ablation (n = 29), the conventional group using X-Ray guide ablation (n = 20), compared two groups of operation time， X-ray fluoroscopy time, X-ray fluoroscopy exposure, cost,complication, achievement and recurrence rate. Results The immediate success rate in 3D group was 100% (29/29), in the conventional group was 95% (19/20); There were 3 cases of complications in the conventional group, but no significant complications in 3D group. Fluoroscopy time of CARTO 3 group was less than X-Ray group[ (1.3±3.6) min vs (44.2±28.2)min,P<0.01], with a correspondingly low radiation exposure[(93±242) mGy vs (3 919±2 309) mGy, P<0.01]. There was no statistically significant difference in total operation time of two groups.In 20/29 (69.0%) RVOT cases, electroanatomical mapping avoided fluoroscopy entirely. Conclusion Our study shows that using 3D electroanatomical navigation system (CARTO 3 system) in RVOT-PVCs ablation is effective and safe,it can markedly reduce fluoroscopy exposure.In many cases, non-fluoroscopic RFCA is feasible. |
| Key words: Cardiology Right Ventricular Outflow Tract Arrhythmias Radiofrequency ablation Electroanatomical mapping X-Ray |
