应用CARTO系统标测和消融房性心动过速的初步经验

Initial Experience of Catheter Ablation of Atrial Tachycardia Using CARTO System

初步探讨CARTO系统在房性心动过速 (简称房速 )标测和射频消融中的临床应用。 5例房速患者 ,年龄 42 .4± 15 .8岁 ,男 3例、女 2例。其中 1例为法氏三联症外科根治术后。心动过速周期 35 5± 76ms。在心动过速时应用CARTO系统标测相关心房 ,实时重建三维电解剖图 ,并用以指导射频放电消融靶点。 5例房速均成功消融。 3例为右房内折返性心动过速 ,其中 1例法氏三联症手术后房速为右房外侧壁手术瘢痕所介导 ,经线性消融关键峡部成功。 2例为局灶性房速 ,起源点分别在右房His束旁和左房后壁。放电次数为 3.5± 2 .1。手术时间为 2 39± 45min ,曝光时间为 14± 9min。结论 :本研究提示应用CARTO系统标测和消融房速 (包括折返性和局灶性 )是可行的。在较少X线曝光下 ,易于标志到最佳靶点和成功消融 ,尤其是对于心脏结构异常和复杂房速的病例。

To explore the role of CARTO system for electroanatomical mapping and ablation of atrial tachycardia(AT),five consecutive patients (age 42.4±15.8 years) with AT were included in this study. The cycle length was 355±76 ms. No cases had structured heart disease except one with congenital trilogy of Fallot after surgical operation. During tachycardia, three dimensional electroanatomical map of the atrium of interest was created using CARTO system, and under its guidance radiofrequency(RF) pulses were delivered.AT was successfully ablated in all five cases with 3.5±2.1 RF pulses.Three cases were intra atrial reentrant tachycardia in right atrium. Among of them, one with scar related AT.Two cases were focal AT(para hisial foci in right atrium and left posterior wall in left atrium respectively).The fluoroscopic time was 14±9 minutes. The procedure time was 239±45 minutes.Conclusion: This study suggests the feasibility of CARTO system mapping and ablation of reentrant and focal AT. Under less fluoroscopic exposure, the optimal target site is easily marked and ablated successfully, especially in the abnormal cardiac anatomy and complex AT.