Carto系统指导下环肺静脉线性消融治疗心房颤动

Circumferential pulmonary vein ablation for atrial fibrillation under guidance of carto system

目的:观察Carto系统指导下环肺静脉线性消融治疗心房颤动的临床疗效。方法:28例心房颤动(阵发性23例,持续性5例)患者行射频消融治疗。Carto系统指导下构建左心房电解剖图,行双侧环肺静脉线性消融,环状标测电极验证肺静脉达到电隔离效果。若术中心房颤动不终止,则继续消融左房顶部线、二尖瓣峡部线或三尖瓣峡部线,如心房颤动仍未终止,遂行同步直流电复律恢复至窦性心律。结果:28例患者均成功完成手术,其中18例只需完成双侧环肺静脉线性消融,10例需要继续行左房顶部线、二尖瓣峡部线或三尖瓣峡部线的消融。随访3～29个月,2例复发房颤,2例复发房性心动过速,所有患者的手术成功率为86%。结论:Carto系统指导下环肺静脉线性消融治疗心房颤动短至中期随访效果确切,具有较高成功率。

Objective：To investigate the effectiveness of circumferential pulmonary vein（PV） ablation for atrial fibrillation （AF） under guidance of Carto system.Methods：Twenty-eight patients with AF （23 paroxysmal AF and 5 permanent AF）underwent circumferential pulmonary vein ablation under guidance of the Carto system. Left atrial maps were reconstructed with Carto system.Radiofrequency ablation was performed to create circumferential lines around each PV,complete PVs electric isolation was confirmed by lasso catheter.If AF persisted,linear lesions on roof of left atrium,mitral isthmus or tricuspid isthmus were created.Finally direct current cardioversion were given if sinus rhythm did not return.Results：All 28 patients were successfully performed with circumferential pulmonary vein ablation.Among them 10 patients were also performed linear lesions on roof of left atrium,mitral isthmus or tricuspid isthmus.During 3-29 months follow up,2 patients recurred with AF,another 2 patients recurred with atrial tachyeardia.The success rate was 86% in the study.Conclusion：Circumferential PV ablation has a good effect on AF.