EnSite NavX三维标测系统与常规X线引导下经主动脉逆行途径治疗左侧旁道的对比观察

Comparison of EnSite NavX three-dimensional mapping system with conventional X-ray guided by aortic retrograde route in the treatment of left accessory pathway

目的探讨EnSite NavX三维标测系统与常规X线指导下射频消融治疗左侧旁道的有效性、安全性及远期疗效的差异。方法选取经主动脉途径行射频消融治疗左侧旁道患者117例,将其分为观察组和对照组,观察组在EnSite NavX三维标测系统引导下,必要时结合短暂X透视进行射频消融治疗;对照组在传统X线透视下行射频消融治疗。观察指标:(1)放置标测导管过程中X线照射时间(T1)和曝光剂量(CD1);(2)操作消融导管进行标测消融过程中X线照射时间(T2)和曝光剂量(CD2);(3)手术时间;(4)即刻成功率与总体成功率;(5)并发症。结果观察组57例患者,对照组60例患者,两组消融即刻成功率100%,随访6个月,对照组1例复发;两组间T1和CD1比较,无显著性差异(P>0.05);与对照组比较,观察组T2和CD2均显著减少,分别为[(7.5±2.3)min vs(12.1±2.6)min,(8.6±2.5)mGy vs(16.4±3.1)mGy;P<0.001]。结论与X线引导下相比,EnSite NavX三维标测系统引导下经主动脉逆行射频消融左侧旁道安全、有效,可缩短X线照射时间,减少X线曝光剂量。

Objective To investigate the difference of effectiveness,safety and long-term efficacy of radiofrequency catheter ablation（RFCA）of left accessory pathway（LAP）under the guidance of EnSite NavX three-dimensional（3D） mapping system and conventional X-ray. Method A total of 117 patients having their LAP treated by aorta RF CA,were classified into the study group and the control group. The study group were guided by I^nSite NavX 3D mapping system, If necessary, combined with short-term X fluoroscopy for radiofrequency ablation. The control group in the traditional X-ray fluoroscopy RFCA.X-ray irradiation times and exposure doses during the course of the operations were recorded.The operative time, success rate and complication were compared between the two groups. Results The observation group of 57 patients,60 patients in the control group,the acute success rate and overall success rate did not differ between the groups. There was no significant difference in T1 and CD1 between the two groups.The X-ray irradiation times and exposure doses in the course of manipulating the ablation catheters were sig- nificantly lower in the study group compared to control group respectively [（7.5 ± 2.3） rain vs （12.1±2.6） min , （8.6±2.5） mGy vs （16.4±3.1）mGy; P〈0.001]. Conclusion Compared with traditional fluoroscopic technique, Ensite Navx 3D system guided by aortic retrograde RFCA of LAP is safe and effective, can shorten the X-ray irradia- tion time,reduce the X-ray exposure dose. I-Chinese Journal of Cardiac Pacing and Electrophysiology,