局部电位标测与影象定位法射频消融心房扑动的对比研究

Compartive Study of Radiofrequency Catheter Ablation of Atrial Flutter by Activation Mapping With by Anatomic Marker Guidance

对１６例心房扑动（简称房扑）患者，８例采用局部电位标测法，８例采用影象定位法进行射频消融。１２例普通型房扑全部消融成功，４例合并非普通型房扑者１例消融成功。局部电位标测法（消融成功５例）平均放电１１．８±４．４次、手术时间２２８．４±６．６ｍｉｎ、Ｘ线照射时间６０．８±１０．１ｍｉｎ；影象定位法（消融成功８例）依次平均为５．３±６．２次、１２２．５±２６．８ｍｉｎ、２９．８±１１．１ｍｉｎ，与前一种方法比较均有显著性差异，Ｐ值分别＜０．０５，０．００５，０．００１。提示后种方法优于前种方法。随访４５．５±２５．５周，３例复发。

Eight consecutive patients with atrial flutter underwent right atrial endocardial activation mapping and the area of slow conduction and the exit site or site near the exit from the area of slow conduction were ablated using radiofrequency(RF)energy in them.Another eight patients underwent ablation of the isthmus between the in terior vena cava and the tricuspid valve under guidance of fluoroscopy.Upon identifying appropriate sites,RF(2540 W)was applied via a 4 mm tipped catheter,and RF was effective in terminating and preventing reinduction of a trial flutter in l2 patients with common type of atrial flutter and one patient with uncommon type of trial flutter.In three patients accompanied with uncommon type of atrial flutter,tachycardia was not terminated.Applications of RF energy,procedure time and fluoroscopic time were 11.8±4.4 times,228.4±6.6 min,60.8±10.1 min and 5.3±6.2 times(P<0.05),122.5±26.8 min(P<0.005),29.8±1.1 min(P<0.001)respectively in the first and second groups.Follow-up(mean 45.5±25.5 weeks)revealed recurrence of atrial flutter in 3 patients.