盐水灌注导管电隔离心房-肺(或上腔)静脉治疗阵发性心房颤动的评价

Evaluation of atrium-pulmonary vein/superior vena cava electrical isolation by irrigated-tip catheter ablation for patients with paroxysmal atrial fibrillation

目的评价盐水灌注导管电隔离心房-肺(或上腔)静脉的效果及安全性。方法69例阵发性心房颤动(房颤)患者,男48例,女21例,平均年龄(55±10)岁,平均病史(4.2±1.1)年。所有患者均采用盐水灌注电极进行肺静脉口部节段性消融,电隔离终点为环状标测电极标测的肺静脉电位全部消失。术后随访症状,心电图及24h动态心电图,以无临床症状及无房颤的心电图证据判定为成功。结果69例共电隔离肺静脉206根,上腔静脉11根,右上肺静脉口外点消融1例。即刻电隔离成功率100%,放电时间(2902.0±1326.3)s。随访时间(118.1±69.7)天,成功率71%。结论应用盐水灌注导管电隔离心房-肺(或上腔)静脉消融安全有效,未见严重并发症发生。

Objective To evaluate the safety and efficacy of segmental isolation of atrium-pulmonary vein （or superior vena eava） by irrigated-tip catheter. Methods Sixty-nine consecutive patients （48 men and 21 women, mean age 56±11, mean disease history 4.2± 1. lyears） with paroxysmal atrial fibrillation （AF） underwent the segmental isolation of atrium-pulmonary vein （or superior vena cava） by irrigated-tip catheter. The endpoint was disappearance of the muscle sleeve potentials recorded by Lasso catheter. The long-term successful rate was determined on the basis of the results of Hoher monitoring and the clinical symptoms. Results 206 pulmonary veins（PVs） and 11 superior vena cava（SVC） were isolated in 69 patients and one focal ablation of right superior pulmonary vein （LSPV） was performed. All PV isolation was achieved during the procedure. Mean duration of the ablation was （2902.0 ±1326.3） seconds. During a mean follow-up period of 118.1±69.7 days, 49 patients （71%） were freed of AF. Conclusion The irrigated-tip ablation is safe and effective.