心腔内超声指导下Marshall静脉无水乙醇灌注心房颤动消融

Atrial fibrillation ablation using vein of Marshall ethanol infusion guided by intracadiac echocardiography

目的 介绍心腔内超声(ICE)指导下Marshall静脉无水乙醇灌注消融心房颤动。方法 选择2022年8月至9月宁波市医疗中心李惠利医院心内科收治的心房颤动患者5例,均在ICE指导下行Marshall静脉无水乙醇灌注消融术,分析Marshall静脉无水乙醇消融的平均操作时间,是否行心外膜补充消融、消融是否恢复窦性心律及并发症情况。结果 5例患者均成功行Marshall静脉无水乙醇消融,且顺利完成双侧环肺静脉前庭消融、左心房顶部线、二尖瓣峡部线和冠状窦心房侧内膜面消融,并验证了5例患者均存在左心房顶部线、二尖瓣峡部线双向传导阻滞。平均操作时间为(30.4±6.4)min。术后均恢复窦性心律。术中均未出现严重并发症。结论 心腔内超声指导下Marshall静脉无水乙醇消融简便可行,安全有效。

Objective To introduce Atrial fibrillation ablation using Vein of Marshall ethanol Infusion guided by intracardiac echocardiography(ICE).Methods A total of 5 inpatients with atrial fibrillation underwent ablation using vein of Marshall ethanol infusion guided by ICE in Department of Cardiology,Ningbo Medical Center Lihuili Hospital,Ningbo from August to September 2022.The average ablation time of vein of Marshall ethanol infusion,whether need of adding epicardial ablation,whether restoration of sinus rhythm,and complications were analyzed.Results The vein of Marshall ethanol ablation was successfully performed in all 5 patients.Also,the ablation of bilateral circumferential pulmonary vein antrum,the left atrial roof line,the mitral isthmus line and the intimal surface of coronary sinus faced to atrium were performed.Bidirectional conduction block along the left atrial roof line and the mitral isthmus line was verified in all 5 patients.The average ablation time of vein of Marshall ethanol infusion was(30.4±6.4)min.Sinus rhythm was restored in all patients without any complication during the procedure.Conclusion The vein of Marshall ethanol infusion ablation guided by ICE is feasible and safe.