三维标测指导下的阵发性室上性心动过速射频消融

Catheter ablation of paroxysmal supraventricular tachycardia using three-dimensional mapping

目的探讨与常规标测相比,三维标测指导下的阵发性室上性心动过速射频消融的可行性、安全性与优势。方法回顾性分析2013年1月至8月,在宁波市第一医院行射频消融术的阵发性室上性心动过速的患者114例,按照标测方法分为三维标测组与常规标测组,比较两组间的射频消融成功率、并发症发生率、手术时间、X线曝光时间与X线曝光量。结果两组所有手术均获得即刻成功,均无并发症发生。两组的手术时间比较,差异无统计学意义[(77.6±28.1)min vs.(70.4±23.2)min,P>0.05]。三维标测组的X线曝光时间与X线曝光量均显著低于常规标测组(中位数:4.2 min vs.15.4 min,P<0.01;中位数:11.0 mGy vs.76.7 mGy,P<0.01),差异有统计学意义。结论阵发性室上性心动过速的射频消融术与常规标测相比,采用三维标测指导具有相同的成功率与安全性,并不延长手术时间,且能显著减少X线曝光时间与X线曝光量。

Objectives To explore the efficacy, safety and advantage of catheter ablation of paroxysmal supraventricular taehyeardia using three-dimensional mapping compared with conventional mapping. Methods We retrospectively analyzed 114 patients with paroxysmal supraventricular tachycardia received catheter ablation in Ningbo First Hospital from January 2013 to August 2013. Comparisons of ablation success rate, complication rate, total procedure time, total fluoroscopy time and total fluoroscopy dose between three-dimensional mapping and conventional mapping were made. Results Catheter ablations in the two groups were immediately successful without any complication. Total procedure time was not significantly different between the two methods[ （77.6±28.1） min vs. （70.4±23.2） min, P〉0.05 ]. There were significant reductions in total fluoroscopy time and total fluoroscopy dose in three-dimensional mapping group compared with conventional mapping group （median： 4.2 rain vs. 15.4 rain, P〈0.01; median： 11.0 mGy vs. 76.7 mGy, P〈0.01）. Conclusions Compared with conventional mapping, using three-dimensional mapping in catheter ablation of paroxysmal supraventricular tachycardia can significantly reduce fluoroscopic exposure without compromising safety, efficacy and procedure time.