国产心脏三维电解剖标测系统引导下射频导管消融持续性心房颤动

Radiofrequency catheter ablation of sustained atrial fibrillation guided by domestic ColumbusTM cardiac three dimensional electromagnetic mapping system

目的应用国产心脏三维电解剖标测系统（ColumbusTM系统）引导持续性心房颤动（房颤）导管消融,观察此系统的精确性和导管消融的有效性和安全性.方法2013年1月至10月在沈阳军区总医院应用国产ColumbusTM系统引导下行环肺静脉电隔离术（CPVI）射频导管消融持续性房颤30例患者,男26例,年龄41～75（59.0±8.8）岁.30例在国产ColumbusTM系统引导下行左心房内环肺静脉电隔离术,部分患者配合左心房顶壁线和/或三尖瓣环峡部线性消融等.结果30例消融组术中均完成环肺静脉电隔离,第12、13例分别行左心房顶壁线或三尖瓣环峡部线消融,均达到消融终点.术中三维解剖定位准确,无移位等发生.术后均完成12个月随访,23例（76.7％）无复发,7例复发房颤（6例）或不典型心房扑动（房扑,1例）,其中1例术后半年再次行射频消融术,随访半年未再复发.所有患者术中及术后随访中均未出现手术相关并发症.结论国产ColumbusTM系统引导下射频导管消融持续性房颤定位准确、疗效确切、安全性高.

Objective To observe the accuracy,effectiveness and safety of radiofrequency catheter ablation （RFCA） of sustained atrial fibrllation （AF） by using the domestic ColumbusTM cardiac three dimensional electromagnetic mapping system （ColumbusTMsystem）.Methods The study population was composed of 30 patients,26 male,mean age 41-75（59.0±8.8） years,with sustained AF for 1-12 months.All the 30 patients underwent circumferential pulmonary vein isolation （CPVI） by using ColumbusTMsystem.In some patients,additional linear ablation of left atrial roof line and/or tricuspid annulus isthmus hne was added.Results The endpoints of CPVI achieved in all the 30 patients.The 12th and 13th patients underwent a linear ablation of the left atrial roof line or tricuspid annulus isthmus line,and a bidirectional conduction block achieved in all patients.During the procedures,the ColumbusTM system had an accurate localization,and had no displacement.There were no serious ablation-related complications during and after the operation procedures.During a period of 12 months of follow-up,23 patients （76.7%） had no AF recurrence,and AF or atypical atrial flutter recurred in 6 and 1 patients.One of the 7 patients underwent a re-ablation procedure,and the patient had no recurrence during 6 months of follow-up.Conclusion Domestic ColumbasTM system was accurate,effective and safe in RFCA of sustained AF.