摘要
目的:研究右心室流出道(RVOT)起源室性早搏(PVC)导管消融时的组织接触压力,并对RVOT常见解剖部位的消融压力进行分析。方法:46例RVOT-PVC患者用压力感知导管进行消融治疗,根据RVOT消融靶点分为间隔组和游离壁组,分析这两组的有效消融压力和压力分布情况。结果:随访3个月,43例RVOT-PVC患者(间隔组和游离壁组分别有20例和23例)未复发,共134个有效消融点,平均消融压力为(12.0±7.5)g,间隔组和游离壁组的有效消融点平均消融压力[(13.0±9.4)g vs(11.0±4.4)g]以及压力适中区(5~15 g)有效消融点比例(39%vs 74%)间的差异均有统计学意义(P均<0.05)。间隔组和游离壁组的有效消融点消融压力相对标准偏差分别为71.5%和40.9%(P<0.01)。随着消融压力增加,电压和阻抗也相应增加。结论:RVOT-PVC消融放电中的平均有效压力为(12.0±7.5)g。RVOT常见消融部位的压力大小和分布趋势显著不同,游离壁RVOT-PVC应采用适中且稳定的压力进行消融。
Objectives: This study aimed to assess the contact force(CF) during ablation of premature ventricular contractions originating from the right ventricular outflow tract(RVOT-PVCs) and analyze the CF data in two(septum, SM and free wall FW) RVOT ablation sites. Methods: CF-sensing catheter ablation was performed in 46 patients with RVOT-PVCs. Patients were divided into two groups according to the target site of RVOT: septum(SM, n=20) group and free wall(FW, n=23) group. The effective ablation CF value and the distribution of CF in SM and FW subgroups were analyzed.Results: Data from 134 successful ablation points were analyzed. The mean CF of all 134 ablation points was(12.0±7.5) g. The mean CF([13.0±9.4] g vs [11.0±4.4] g, P〈0.05) and the relative standard deviation(RSD, 71.5% vs 40.9%, P〈0.05) were significantly higher in SM group than in FW group, while percent of moderate CF(5-15 g) was significantly lower in SM group than in FW group(39% vs 74%, P〈0.05). Electrogram amplitudes and impedance values increased in proportion to increasing CF. There was no PVCs recurrence during the 3 months follow-up. Conclusions: The optimal CF in the phase of energy application during RVOT-PVCs ablation is(12.0±7.5) g, there are significant difference in mean CF, RSD and percent of moderate CF between the SM and FW groups. The modest and stable CF is needed for ablating RVOT-PVCs in the free wall.
作者
单亮
唐闽
陈柯萍
张澍
SHAN Liang, TANG Min, CHEN Ke-ping, ZHANG Shu(Cardiac Arrhythmia Center, National Center for Cardiovascular Diseases and Fuwai Hospital, CAMS and PUMC, Beijing (100037), China)
出处
《中国循环杂志》
CSCD
北大核心
2018年第7期681-684,共4页
Chinese Circulation Journal
关键词
导管消融
接触压力
右心室流出道
室性早搏
Catheter ablation
Contact force
Right ventricular outflow tract
Premature ventricular contractions