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Carto-Merge技术指导下肺静脉前庭电解剖隔离的初期经验
赵亮,张家友,赵学,杜荣增,赵伟,姜其钧,夏阳,廖德宁*
0
(第二军医大学长征医院心内科,上海 200003)
摘要:
目的:介绍应用CartoMerge技术将左心房和肺静脉CT三维重建图像与Carto电解剖标测图像相整合,指导肺静脉前庭电解剖隔离治疗心房颤动的初期经验。方法:对13例阵发性和2例持续性房颤患者,应用CartoMerge技术进行肺静脉前庭电解剖隔离。结果:消融前左心房各壁标测点为(103±13)个;图像融合后,点与面之间的配准距离为(1.8±0.2) mm;环左肺静脉消融点(66±15)个,环右肺静脉消融点(58±20)个;所有患者均达到肺静脉电隔离;手术时间(305±45) min,透视时间(52±18) min;术中、术后无并发症发生。结论:CT三维重建后的图像接近真实解剖,与Carto电解剖标测图像的整合图像可帮助术者校正和弥补Carto电解剖图像的不足,有助于提高手术成功率,减少并发症。
关键词:  Carto  体层摄影术,X线计算机  肺静脉  心房颤动
DOI:10.3724/SP.J.1008.2007.01214
投稿时间:2007-03-17
基金项目:
Three-dimensional electroanatomic mapping with Carto-Merge to guide catheter ablation of atrial fibrillation: an initial experience
ZHAO Liang,ZHANG Jia-you, ZHAO Xue, DU Rong-zeng, ZHAO Wei, JIANG Qi-jun, XIA Yang, LIAO De-ning*
(Department of Cardiology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China)
Abstract:
Objective:To summarize our initial experience on threedimensional electroanatomic mapping with CartoMerge, so as to provide evidence for guiding catheter ablation of atrial fibrillation (AF). Methods: Fifteen patients with paroxysmal/persistent AF (13 paroxysmal and 2 persistent), who were to receive catheter ablation, were analyzed by CARTOMERGE, which combines computed tomography (CT) angiography, picture merging, guiding ablation, etc. Results: There were 103±13 mapping points before ablation, with 66±15 in the left ablation circle and 58±20 in the right. The distance between points and surface was (1.8±0.2) mm in the merged images. Operation time was (305±45) min and the Xray exposure time was (52±18) min. Isolation of pulmonary veins potential was achieved in all patients and there was no complication during the operation. Conclusion: Threedimensional CT images is very close to the the real anatomy of left atrium and pulmonary veins. Cartomerge technique can overcome some shortcomings of Carto electroanatomic mapping pictures, which can improve the successful rate of operation and reduce complications.
Key words:  Carto  tomography,X ray computed  pulmonary veins  atrial fibrillation