低X线曝光下EnSite NavX三维标测系统引导射频消融房室结折返性心动过速

Research on the application of radiofrequency ablation of atrioventricular nodal reentrant tachycardia under the EnSite NavX mapping guidance and low-frequency ray

目的评价在低频率X线曝光下应用EnSite NavX三维标测系统引导射频消融房室结折返性心动过速(AVNRT)的安全性、有效性。方法选择2011年4月至2015年2月在本院住院的阵发性室上性心动过速患者,经食管调搏筛选出103例AVNRT。将入选患者分为研究组61例和常规组42例。研究组低频率X线曝光下应用NavX指导消融,常规组X线透视消融。观察两组的手术成功率、手术操作时间、放电次数、放电时间、X线曝光时间和并发症。结果研究组中2例经术中心内电生理检查诊断分别更正为房性心动过速和间隔旁道致房室折返性心动过速而剔除出组,其余研究组及常规组均成功完成手术。与常规组比较,研究组手术时间减少[(46.5±11.7)min vs(63.4±14.5)min,P<0.01],X线曝光时间明显缩短[(192±103)s vs(413±112)s,P<0.01],放电次数显著减少[(3±1)次vs(7±2)次,P<0.01],放电时间显著缩短[(184±69)s vs(378±77)s,P<0.01]。术中常规组发生1例房室传导阻滞。结论低频率X线曝光下在EnSite NavX三维标测系统引导射频消融治疗AVNRT安全,在缩短X线曝光时间的同时提高了手术效率。

Objective To evaluate security and effectiveness of radiofrequency catheter ablation（RFCA） of atrio- ventricular nodal reentrant tachycardia （AVNRT） under the EnSite NavX mapping guidance and low-frequency ray. Methods One hundred and three patients with AVNRT received RFCA were divided into mapping group using the EnSite NavX system and conventional group using X-ray. The fluoroscopy time, operation time, discharging number, discharging time and occurrence of complications were compared between two groups. Results There was no difference in success rate between two groups. While EnSite NavX group used the mean fluoroscopy time was significantly shorter than conventional group[（192± 103）s vs（413± 112）s, P〈0.01], and for overall discharging number significantly decreased[（3±1）times vs（74-2）times, P〈0.01], discharging time[（184±69）s vs（378 77） s, P〈 0.01 ], and further more operation time significantly shorter[ （46.5 ±11.7） min vs （63.4 ±14.5 ） rain, P 〈0.01]. Conclusion RFCA of AVNRT by the EnSite NavX system is safe and effective. It can reduce X-ray fluoroscopy time and operation time. [Chinese Journal of Cardiac Pacing and Electroph ysiology ,2016,30（2）：138-140]