新型三维电生理成像标测导航系统指导射频消融心房颤动的有效性和安全性

Efficacy and safety of a novel three-dimensional electrophysiological mapping and navigation system to guide radiofrequency ablation of atrial fibrillation

目的探讨新型三维电生理成像标测导航系统指导射频消融心房颤动的有效性与安全性。方法本文为回顾性研究。入选2020年10月至2021年7月,于中国医学科学院阜外医院心律失常中心接受新型三维电生理成像标测导航系统指导下行射频消融的心房颤动患者。所有患者经非压力监测盐水灌注消融导管行肺静脉隔离。回顾性分析急性期肺静脉隔离率、左心房建模及消融时间、并发症及术后随访结果。结果共纳入患者23例,年龄(58.3±8.2)岁,其中男17例(73.9%,17/23),阵发性心房颤动17例(73.9%,17/23),左心房前后径(41.3±4.4)mm,左心室射血分数(56.0±65.0)%。23例(100%,23/23)患者术中均成功隔离肺静脉。射频消融时间为(1823.4±456.9)s。围术期未出现气爆、导管嵌顿、心脏压塞、心房食管瘘或其他并发症。随访12.2(7.8,13.0)个月,16例(69.6%,16/23)患者无心房颤动复发,17例(73.9%,17/23)患者遵医嘱停用抗心律失常药物。结论应用新型三维电生理成像标测导航系统指导非压力监测导管射频消融心房颤动具有良好的有效性和安全性。

Objective To investigate the efficacy and safety of the novel three-dimensional electrophysiological mapping and navigation system to guide radiofrequency ablation of atrial fibrillation(AF).Methods The patients were enrolled who underwent radiofrequency ablation of AF guided by the novel three-dimensional electrophysiological mapping and navigation system in Fuwai Hospital,from October 2020 to July 2021.Pulmonary vein isolation(PVI)was performed on all patients using the irrigated tip catheter without a contact force sensor.The acute PVI rate,the duration of left atrial remodeling and ablation,complications,and postoperative follow-up results were analyzed retrospectively.Results Twenty-three patients were enrolled with an average age of(58.3±8.2)years,including 17 in male(73.9%,17/23)and 17 cases of paroxysmal AF(73.9%,17/23).The mean left atrial anteroposterior diameter was(41.3±4.4)mm,and the mean left ventricular ejection fraction was(56.0±65.0)%.All pulmonary veins of the 23(100%,23/23)patients were acutely isolated.The radiofrequency ablation time was(1823.4±456.9)s.There were no steam pops,catheter retention,pericardial tamponade,atrioventricular esophageal fistula,or other complications perioperatively.At 12.2(7.8,13.0)months of follow-up,16 patients had no recurrence of AF(69.6%,16/23),and 17(73.9%,17/23)patients discontinued antiarrhythmic drugs as prescribed.Conclusion It is effective and safe to ablate AF using an irrigated tip radiofrequency catheter without a contact force sensor with the guidance of the novel three-dimensional electrophysiological mapping and navigation system.