对比普通与灌注冷却射频消融电极在Ⅰ型心房扑动消融中的作用

Comparing the effects of common ablation catheter and irrigated ablation catheter on common atrial flutter

目的对比普遍与灌注冷却射频消融电极在Ⅰ型心房扑动（ＣＡＦＬ）消融中的作用。方法６０例ＣＡＦＬ患者随机分为两组：普通射频消融电极治疗组（ＣＲＦ）和灌注冷却射频消融电极治疗组（ＩＲＦ），分别比较两组取得下腔静脉与三尖瓣环峡部双向阻滞的手术时间、Ｘ线照射时间、射频消融放电次数及放电时间、并观察消融时电能、阻抗以及温度的改变。结果ＩＲＦ组的手术时间、Ｘ线照射时间、射频消融时间均较ＣＢＦ组短（Ｐ＜０．０１），放电次数也少（Ｐ＜０．０５），ＩＲＦ组消融过程中阻抗变化小、电能稳定，温度差异不明显，而ＣＲＦ组则相反，且有１９例出现碳化现象，两组痛感差异无显著性，均无心包填塞、栓塞等并发症。结论灌注冷却射频消融电极在ＣＡＦＬ消融中优越于普通射频消融电极。

Objective To compare the effects of common ablation catheter and irrigated ablation catheter on common atrial flutter (CAFL). Methods 60 patients with CAFL were randomly dividied into common catheter group (CRF, 30cases) and irrigated catheter group (IRF, 30 cases). The procedure duration, fluoroscopy duration and radio frequeney duration were studied. The RF energy,impedance and temparature during the ablation were observed. Results The duration of procedure, fluoroscopy time and radio frequency ablation time were significantly shorter in IBF group than those in CBF group (P <0.01), there was also a difference in the times of ablation between two groups (P < 0.05). In IRF group, the variation of impedance, RF-energy and temperature during the ablation was small, but in CBF group, the variation was obvious and there were 19 cases with coagulum formation. The degree of the chest pain was similar between two groups, there were no serious complications such as pericardial effusion, thrombi etc. Conclusion Irrigated ablation catheter should be superior to common ablation catheter in CAFL ablation.