国产三维电解剖标测系统导引房室结折返性心动过速经导管射频消融的临床研究

Domestic three-dimensional electroanatomic mapping system for guiding radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia: a clinical study

目的评价国产Columbus三维电解剖标测系统导引房室结折返性心动过速(AVNRT)经导管射频消融(RFCA)治疗的安全性和有效性。方法回顾性分析2016年1月至2018年2月在郑州大学附属洛阳中心医院确诊为AVNRT并接受RFCA治疗患者160例,分为传统二维消融组(n=100)和国产三维消融组(n=60)。比较两组患者手术时间、X线曝光时间、放电消融时间、即刻消融成功率、并发症发生率、术后1年心动过速复发率。结果两组患者手术即刻成功率均为100%。国产三维消融组手术时间稍长于传统二维消融组[(65.5±14.7)min对(58.4±11.3)min,P<0.05],X线曝光时间显著缩短[(3.5±2.4)min对(15.3±1.8)min,P<0.05];两组放电消融时间差异无统计学意义[(160±35)s对(180±20)s,P>0.05],并发症发生率、1年复发率差异均无统计学意义。结论国产Columbus三维电解剖标测系统导引RFCA治疗AVNRT可明显缩短X线曝光时间,安全有效。由于初期应用Columbus系统,整体手术时间可能略长。

Objective To evaluate the safety and effectiveness of domestic three-dimensional electroanatomic mapping system(Columbus)in guiding radiofrequency catheter ablation(RFCA)for atrioventricular nodal reentrant tachycardia(AVNRT).Methods The clinical data of 160 patients with proved AVNRT,who were admitted to the Affiliated Luoyang Central Hospital of Zhengzhou University of China during the period from January 2016 to February 2018 to receive RFCA therapy,were retrospectively analyzed.The patients were divided into traditional two-dimensional ablation group(n=100)and domestic three-dimensional ablation group(n=60).The time spent for operation,X-ray exposure time,discharge ablation time,immediate ablation success rate,and recurrence rate of tachycardia one year after RFCA were compared between the two groups.Results The immediate success rate of operation was 100%in both groups.In domestic three-dimensional ablation group,the operation time was(65.5±14.7)min,which was slightly longer than(58.4±11.3)min in the two-dimensional group(P<0.05);the X-ray exposure time was(3.5±2.4)min,which was signif-icantly lower than(15.3±1.8)min in the two-dimensional group(P<0.05).No statistically significant difference in the discharge ablation time(160±35 seconds versus 180±20 seconds)as well as in the incidence of complications and one-year recurrence rate existed between the two groups(P>0.05).Conclusion For the treatment of AVNRT,RFCA guided by domestic three-dimensional electroanatomic mapping system(Columbus)can remarkably shorten X-ray exposure time,and this technique is clinically safe and effective.It is only the initial application of the Columbus system,which might make the whole operation time slightly longer.(J Intervent Radiol,2020,29:714-717)