摘要
目的在EnSite NavXTM三维电标测系统指导下零X线曝光下射频导管消融(RFCA)治疗阵发性室上性心动过速(PSVT)。方法 53例行RFCA的PSVT患者,房室结折返性心动过速(AVNRT)25例,房室折返性心动过速(AVRT)28例,其中右侧旁道(AP)10例,左侧AP18例。在EnSite NavXTM三维电标测系统指导下放置冠状静脉窦(CS)、His束及右房/右室(RA/RV)标测导管并行心电生理检查,消融大头导管(ABL)进入拟消融区域建模、消融。结果 53例中,49例采用该方法消融成功,成功率92.5%(49/53)。手术时间:76.6±29.6 min。1例左侧隐匿AP患者由于术中癔症发作而改用X线透视下消融;2例显性AP患者(右侧游离壁1例,左后游离壁1例)用温控消融导管在靶点处反复放电无效后,在X线透视下用冷盐水灌注导管阻断AP。1例右侧显性AP患者1个月后复发(1/50),在X线透视下再次消融成功。所有病例无并发症出现。结论利用EnSite NavXTM三维电标测系统可在无X线曝光下完成RFCA治疗PSVT。
Objective Clinical report to the nonfluoroscopic catheter ablation for paroxysmal supraventricular tachycardia （PSVT） cases guided by EnSite NavXTM system. Methods Fifty-three patients underwent radiofrequency catheter ablation （ RFCA）, including 25 patients with atrioventricular nodal reentrant tachycardia （ AVNRT）, 28 patients with atrioventricule reentrant tachycardia（AVRT） （right-sided accessory pathway 10 cases,left-sided 18 cases）. The electrode catheters were intreduced into the right-atrium, His bundle, right-ventricular apex and the coronary sinus（ CS）, guided by NavXTM system. After the electrophysiology studies, three-dimensional anatomic map of interest were created by the ablation catheter （ABL） guided by NavXTM system, the location of specific points was marked. When a good candidate for ablation was decided, radiofrequency energy was delivered and the lesions were marked on the chamber model for future reference. Results Procedural success was achieved in 49 of 53 patients（92.5% ）, operation time was 76.6±29.6 rain. 1 case（left-side concealed AP） underwent RFCA with fluoroscopic procedure for the hysteria onset, saline-irrigated catheter ablation were performed in 2 overt AP cases （ 1 right free-wall, 1 left posterior free-wall ） with X-ray exposure after the failure in nonfluoroscopic procedure with conventional catheter ablation. 1 case（ right-side overt AP） recurrent in 1 month,and re-ablation was done successfully with fluoroscopic procedure. No complications were founded. Conclusions RFCA can treat PSVT without X-ray exposure guided by EnSite NavXTM system.
出处
《中国心脏起搏与心电生理杂志》
2013年第1期22-25,共4页
Chinese Journal of Cardiac Pacing and Electrophysiology
