Carto-Merge指导下导管消融治疗阵发性房颤的初步体会

Initial experience of catheter ablation in treatment of paroxysmal atrial fibrillation guided by Carto-Merge

目的运用64排螺旋CT图像与CARTO三维电解剖标测整合技术(Carto-Merge)指导阵发性房颤的导管消融治疗。方法22例经抗心律失常药物治疗效果欠佳的患者进行手术,患者术前1～3d行64排CT心脏成像检查,并将CT导入有Carto-Merge的软件包进行三维重建,重建后在Carto-Merge指导手术。结果所有患者均顺利完成手术,Carto-Merge整合误差为(1.8±0.62)mm,使用Carto-Merge患者平均手术时间为(98±28)min,X线曝光时间为(26±11)min。随访1～6个月,20例均无PAf发作,2例发作次数明显减少,所有患者术中术后均无严重并发症。结论Carto-Merge技术可有效地指导阵发性房颤的射频消融,简化操作,提高消融手术的成功率。

Objective To investigate the effectiveness and advantages of the Carto-Merge technique in guiding catheter ablation of paroxysmal atrial fibrillation（PAF）. Methods Twenty-two patients with drug-refractory PAf were finished 64-slice CT image 1 ～ 3 days before ablation. 64-slice CT scan combined with Carto image was performed by using Carto-Merge software and guiding ablation. Results All patients were successfully achieved the endpoint of ablation. Integration error of Caro-Merge was （1. 8 ± 0. 62） mm. The mean procedure time was （98 ± 28） min in Merge group. The X-ray exposed time was （26 ± 11） min in Merge group. During the for 1 ～ 6 months,20 patients had no occurance of PAF again and Ⅰ had less occurane times. All patients had no severe complications. Conclusion Carto-Merge technique can shorten the ablation and X-ray exposed time,also improve safety and effectiveness.