三维电解剖标测系统指导下环肺静脉线性消融治疗心房颤动的临床应用

Three-dimensional mapping system for guiding circumferential pulmonary vein linear ablation in patients with atrial fibrillation

目的报道10例在三维电解剖标测(Carto标测)指导下环肺静脉线性消融治疗心房颤动的结果和体会。方法 8例阵发性和2例持续性心房颤动患者采用Carto标测构建左心房三维电解剖图,行肺静脉造影了解其形态,围绕左侧和右侧肺静脉口线性消融,对肺静脉进行隔离。结果 10例患者均完成预定的环肺静脉前庭隔离线性消融(CPVA)。1例持续性心房颤动患者术后l^2 d有心房颤动复发并自行转复。术后无一例并发症出现。随访6~12个月,平均(8±4)个月,10例患者未发生有症状的心房颤动。结论环肺静脉线性电隔离治疗心房颤动有较好的治疗效果,但也存在一定的并发症和复发可能性,仍需积累更多病例和做更长时间的观察。

Objective To report the outcomes and experience of circumferential pulmonary vein linear ablation guided by Carto system in 10 patients with atrial fibrillation.Methods Three-dimensional electroanatomical figure of the left atrium was depicted in eight patients with paroxysmal atrial fibrillation（AF） and two with persistent AF using Carto system.The structure of left atrium was detected via pulmonary venous imaging,and linear ablation was performed surrounding bilateral openings of pulmonary veins,which were then separated.Results All patients completed the scheduled circumferential pulmonary vein antrum linear ablation.AF recurred 1~2 days after ablation in one patient but managed to recover to sinus rhythm automatically.No postoperative complication was reported.None of the patient had symptomatic AF during a follow-up period of（8±4） months（range： 6~12 months）.Conclusion Circumferential pulmonary vein antrum linear ablation achieved preferable efficacy.However,observation on more profiles and extensive follow-up study are needed due to certain complications and possible recurrence of AF.