心房颤动消融时图像融合技术再评价

Revaluation of CartoM erge technology in the new operating environment

目的介绍压力导管、可建模环形电极导管等新操作环境下CartoM erge技术的使用经验。方法共纳入24例阵发性心房颤动患者,分为CartoM erge组(实验组,n=16)和常规方法组(对照组,n=8),实验组通过环形电极导管构建肺静脉结构后与电子计算机X射线断层扫描(CT)图像融合,对照组不进行CT融合。两组均采用压力导管进行双侧肺静脉隔离。采集两组患者的一般资料、建模时间、左/右侧肺静脉隔离时间、总手术时间、X线曝光时间、放电时间、左/右侧肺静脉一次隔离成功率、术后窦性心律维持率,比较两组之间的差异。结果两组患者一般资料无统计学差异,实验组的建模时间[(5.4±1.6)min vs(11.6±2.4)min]、总手术时间[(68.3±13.9)min vs(148.8±43.9)min]、左/右侧肺静脉隔离时间、X线曝光时间、放电时间均短于对照组,左/右侧肺静脉一次隔离成功率高于对照组(左侧:14/16 vs 2/8;右侧:16/16 vs 4/8),两组术后3个月和6个月窦性心律维持率之间无统计学差异(术后3个月:12/16 vs 5/8;术后6个月:9/12 vs 3/5)。结论在新的操作环境下,与常规方法相比,CartoM erge技术能够缩短手术时间和X线曝光时间,提高即刻消融成功率。

Objective To introduce the using experience of CartoMerge technology in the new operating environment in- cluding contact force monitoring catheter and new mapping circular electrode. Methods 24 patients with paroxysmal at- rial fibrillation were enrolled and divided into CartoMerge group （experimental group, n = 16） and conventional method group （ control group, n = 8）. Structure of pulmonary veins and left atrium was constructed by circular electrode and fused with CT image in the experimental group. CT fusion was not conducted in the control group. Contact force monitoring cathe- ter was employed in both groups for bilateral pulmonary vein isolation. The baseline characteristics, time for constructing the left atrium, time for left/right pulmonary vein isolation, total operation time, X-ray exposure time, ablation time, im- mediate success rates of left/right pulmonary vein isolation, postoperative success rate were collected and compared. Re- suits The baseline characteristics were similar between the two groups. Compared with the control group, time for con- structing the left atrium [ （5.4 ± 1.6） min vs （11.6±2.4） rain ], total procedure time [ （68.3±13.9 ） min vs （ 148.8 ±43. 9） min ], time for left/right pulmonary vein isolation, X-ray exposure time, ablation time were shorter, and immediate suc- cess rates of left/right pulmonary vein isolation were higher in the experimental group （left： 14/16 vs 2/8 ;right： 16/16 vs 4/8）. There was no statistical difference of 3-month or 6-month postoperative success rate between the two groups （3- month ：12/16 vs 5/8 ;6-month ：9/12 vs 3/5）. Conclusions In the new operating environment, CartoMerge technology can shorten the operation time and X-ray exposure time, improve the immediate success rate of ablation.