Clinical Study on the Treatment of 325 Cases of Atrioventricular Node Reentrant Tachycardia by Radiofrequency Catheter Ablation

In order to improve the efficacy of modified inferior method or middle method of radiofrequency catheter ablation (RFCA) in the treatment of atrioventricular node reentrant tachycardia (AVNRT), the clinical data of 325 cases of AVNRT from March 1992 to Feb. 2000 being subjected to the treatment of RFCA were retrospectively analyzed. The results showed that the successful rate was increased and recurrence was decreased year by year. In the recent 4 years the effective rate was up to 100 %. The complication of three grade of AVB occurred in 3 % and recurrent rate in 9.1 % before March 1996, but both of them were zero in the last 3 years. The time of RFCA procedure and X ray exposure was significantly reduced. It was concluded that ablating more than 3 targets by modified inferior method or middle method with energy titrating and strict endpoint was the crux of obtaining satisfactory therapeutic effects and preventing recurrence.

Radiofrequency catheter ablation of atrial tachycardias related to myocardial scar or incision

Intra-atrial re-entrant tachycardias (IARTs) are common late after heart surgery. Conventional mapping and ablation is relatively difficult because of the complicated anatomy and multiple potential re-entry loops. In this study we aimed to evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) induced by myocardial scar or incision. Methods In 6 patients (three male and three female, aged 33.3+ 11.8 years) who had AT related to myocardial scar or incision,electrophysiological study and radiofrequency catheter ablation (RFCA) were performed. Earliest activation combined with entrainment mapping was adopted to determine a critical isthmus. Results Re-entry related to the lateral atriotomy scar was inducible in 5 of6 patients. With entrainment mapping, the PPI (post-pacing interval)-TCL (tachycardia cycle length) difference was ＜30 ms when pacing at the inferior margins of the right lateral atriotomy scar. Among them, 3 patients had successful linear ablation between scar area to inferior vena cava, and 2 patients between scar area to tricuspid annulus. Re-entry involving an ASD patch was demonstrated in 1 of 6 patients. PPI-TCL differences ＜30 ms were observed when entraining tachycardia at sites near the septal patch. But linear ablation failed in terminating AT. There was no complication during procedure. No recurrence of AT related to incision was observed during follow-up except for the failed patient. Conclusion Under conventional electrophysiological mapping, adopting linear ablation from scar area to anatomic barrier, successful ablation can be obtained in patients with IRATs related to myocardial scar or incision.

Radiofrequency Catheter Ablation Of Inappropriate Sinus Tachycardia

Objective:To investigate the mechanism of inappropriate sinustachycardia and the safety,effectiveness on radiofrequency catheterablation of it.Methods:Radiofrequency catheter ablation wasperformed on a 52-year-old female patient and changes in Holter,heart rate variability,intrinsic heart rate and syndromes were comparedbetween before and after radiofrequeney catheter ablation.Results:The inappropriate sinus tachycardia could not be induced and terminatedby atrial program electric stimulation and burst stimulation,whichsuggests that the mechanism of inappropriate sinus tachycardia isreentry.After radiofrequency catheter ablation,the total heart beatsdecreased from 173490 to 129172 times,the lowest heart rate did from79 to 71 bpm,the highest heart rate from 200 to 122 bpm,the averageheart rate from 117 to 90 bpm,and intrinsic heart rate from 166 to 93Variables of heart rate variability varied too.PNN50 increased from O to11,RMSSD did from 8 to 35.However,LF/HF ratio decreased from12.23 to 0.86.Transesophageal eleetrophysiologic studies demonstratethat sinoatrial node function is normal after radioflequency catheterablation.The patient has been followed up for six months,she has beenbeing free of palpitation,chest distress and dizziness,etc.Conclusion:The inappropriate sinus tachycardia could be due to abnormal sinoatrialnodal automaticity resulting from excessive sympathetic nerve influencesor deficient vagal nerve influences and modification of sinus node withradiofrequency catheter ablation is a safe,effective method for thetreatment of inappropriate sinus tacbycardia.

Delayed papillary muscle rupture after radiofrequency catheter ablation: A case report

BACKGROUND With an increased number of surgical procedures involving the mitral annular region,the risk of mitral valve prolapse(MVP)has also increased.Previous studies have reported that worsening of MVP occurred early after radiofrequency catheter ablation(RFCA)at papillary muscles in ventricular tachycardia(VT)patients with preoperative MVP.CASE SUMMARY We report a case where MVP and papillary muscle rupture occurred 2 wk after RFCA in a papillary muscle originated VT patient without mitral valve regurgitation or prolapse before.The patient then underwent mitral valve replacement with no premature ventricular contraction or VT.During the surgery,a papillary muscle rupture was identified.Pathological examination showed necrosis of the papillary muscle.The patient recovered after mitral valve replacement.CONCLUSION Too many ablation procedures and energy should be avoided.

Radiofrequency ablation of atrial tachycardia in patients with repaired atrial septal defect

Objective:To evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) in patients with repaired atrial septal defects(ASD). Methods: In 76 consecutive patients with AT who underwent the electrophysiological study and radiofrequency catheter ablation (RFCA). 4 patients (one male and three female aged 35. 5±11. 5 years) had AT-related myocardial scar or incision. Earliest activation combined with entrainment mapping was adopted to determine a critical isthmus. Results: Re-entry related to the lateral atriotomy scar was inducible in 3 of 4 patients. With en-trainment mapping, the PPI-TCL difference was <30 ms when pacing at the inferior margins of the right lateral atriotomy scar. Among them, 2 patients had successful linear ablation between scar area to inferior vena cava, and 1 patient between scar areas to tricuspid annulus. Re-entry involving an ASD patch was demonstrated in 1 of 4 patients. PPI-TCL differences <30 ms were found when entraining tachycardia at sites near the septal patch. But linear ablation failed in terminating AT. There was no complication during procedure. No recurrence of incision-related AT was found during follow-up except for the failed patient. Conclusion: Under conventional electrophysiological mapping, adopting linear ablation from scar area to anatomic barrier, successful ablation also can be obtained in patients with IRAT related to myocardial scar or incision.

Role of catheter ablation of ventricular tachycardia associated with structural heart disease

In patients with structural heart disease, ventricular tachycardia (VT) worsens the clinical condition and may severely affect the shortand long-term prognosis. Several therapeutic options can be considered for the management of this arrhythmia. Among others, catheter ablation, a closed-chest therapy, can prevent arrhythmia recurrences by abolishing the arrhythmogenic substrate. Over the last two decades, different techniques have been developed for an effective approach to both tolerated and untolerated VTs. The clinical outcome of patients undergoing ablation has been evaluated in multiple studies. This editorial gives an overview of the role, methodology, clinical outcome and innovative approaches in catheter ablation of VT.

MANAGEMENT OF SOME SPECIAL PROBLEMS IN RADIOFREQUENCY ABLATION

At present,radiofrequency abtation has being the first method for treatment of WPWsyndrome and dual AVN pathway with reentrant supraventricular tachycardia.Review 110cases in our hospital,there are some special problems.Reported here:1.Patient with DDO permanent pacemaker.The function of pacemanker was interfered byradiofrequency cunrrent and changed to DOO.It recurvered Immedlally after discharge.Longtimes follow up there is no desfunction of the pacemaker.2:WPW with paroxysmal atrial fibrMation:Two weeks before ablation,oral amiodaron(200-400mg a day)can effective prevent the occurmence of atrial fibrMation.3.D not appear accessory pathway reterograde:During precedure,when accessorypathway reterograde do not appear,Intravenous lsoptin drip can prolong the refractoryperiod of AVN.It can cause reappearance of the accessory pathway reterograde.4:"Slow conduction"In accessory pathway.As discharge repeatedly at target,conduction ofaccessory pathway was slower.But SVT can still be induced.The YA(or AV)of tapget is notmiscible.Distinguish of the earlist A(or V)is the key of successful abtation.5.Accessory pathway with dual AVN pathway:Phttents with accessory pathway can withdual AVN pathway.Most of them are no clinical significance.Weather ablation or not,atsame time,is decided by the induction of AVNRT.6.Dual AVN pathway with AV block:Dual AVN pathway with AH prolonged slightly is not acontraindication of abletion.But the target should be far from the bundle of His.Lower powerand shorter time should be given and closely observe the change of AV interval.

血清LPS、LOXL2与阵发性心房颤动患者射频导管消融术后复发的相关性

目的探讨血清脂多糖(LPS)、赖氨酰氧化酶样蛋白2(LOXL2)与阵发性心房颤动(PAF)患者射频导管消融(RFCA)术后复发的相关性。方法选取2020年5月—2022年5月在内蒙古自治区人民医院急诊心血管内科行RFCA术的PAF患者197例(PAF组),同期医院体检健康者78例(健康对照组)。PAF组患者RFCA术后随访1年,根据是否复发分为复发亚组63例和未复发亚组134例。采用酶联免疫吸附法检测血清LPS、LOXL2水平;多因素Logistic回归分析PAF患者RFCA术后复发的因素,受试者工作特征(ROC)曲线分析血清LPS、LOXL2水平对RFCA术后复发的预测价值。结果与健康对照组比较,PAF组血清LPS、LOXL2水平升高(Z=5.575、6.903,P均<0.001)。197例PAF患者RFCA术后1年复发率为31.98%(63/197)。与未复发亚组比较,复发亚组血清LPS、LOXL2水平升高(Z=6.431、6.543,P均<0.001)。病程较长、左心房内径(LAD)增加、LPS升高、LOXL2升高为PAF患者RFCA术后复发的独立危险因素[OR(95%CI)=2.335(1.450~3.761)、1.289(1.049~1.586)、1.025(1.014~1.035)、1.004(1.002~1.006)];血清LPS、LOXL2及二者联合预测的AUC为0.784、0.789、0.859,二者联合的AUC大于血清LPS、LOXL2水平单独预测的AUC(Z/P=2.549/0.011、3.000/0.003)。结论PAF患者血清LPS、LOXL2水平升高,是PAF患者RFCA术后复发的独立危险因素,血清LPS、LOXL2水平联合检测对PAF患者RFCA术后复发有较高的预测价值。

Radiofrequency catheter ablation of idiopathic ventricular tachycardia and symptomatic premature ventricular contraction originating from valve annulus

Background Radiofrequency catheter ablation （RFCA） has been established as an effective and curative therapy for ventricular tachycardia （VT） and severely symptomatic premature ventricular contraction （PVC） from the outflow tract in structurally normal hearts. This study aimed to investigate electrophysiologic characteristics and effects of RFCA for patients with idiopathic VT and symptomatic PVC originating from the valve annulus. Methods Characteristics of body surface electrocardiogram （ECG） and endocardiogram in a successful RFCA target were analyzed in 16 patients with idiopathic VT and symptomatic PVC originating from the valve annulus. Additionally, the ECG characteristics of VT or PVC were compared with those of manifest Wolff-Parkinson-White （WPW） syndrome originating from the same site of origin in 15 patients. Results Thirteen patients were successful, 2 recurrent and 1 failed. The recurrent cases underwent successful ablation the second time guided by the Ensite 3000 mapping system. In all patients with the WPW syndrome, the characteristics of QRS morphology were well matched with those of the VT and PVC that originated from corresponding sites of origin. Conclusions RFCA is an effective curative therapy for VT and There are specific characteristics in ECG and the ablation site accessory pathway＇s algorithm. symptomatic PVC originating from the valve annulus. could be located by means of the WPW syndrome

Radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia guided by magnetic navigation system： a prospective randomized comparison with conventional procedure

Background Atrioventricular nodal reentrant tachycardia （AVNRT） is one of the most common paroxysmal supraventricular tachyarrhythmias. The aim of the study was to prospectively compare the characteristics of radiofrequency catheter ablation of AVNRT guided by a magnetic navigation system with the conventional procedure. Methods Patients with AVNRT diagnosed by electrophysiological tests were randomized into two groups. In the conventional technique group （CMT）, a common 4-mm-tip quadrapolar temperature-controlled ablation catheter was used. In the magnetic navigation system guidance group （MNS）, a magnetic 4-mm-tip quadrapolar temperature-controlled ablation catheter was used. The following parameters were collected and compared between the two groups： ablation procedure time, patient fluoroscopy time, operator fluoroscopy time, energy delivery numbers, maximal energy per deployment, success rate, complication rate and operative cost. Results Forty patients were enrolled and randomized into CMT and MNS groups. The age, gender, tachycardia history and basic cardiovascular diseases of the two groups were comparable （P 〉0.05）. All procedures were conducted successfully without complications. No tachycardia recurred during the follow-up period of （9.3±2.6） months. In the MNS group, the patient and operator fluoroscopy times （（11.5±4.3） min, （4.2±1.5） min）, energy delivery numbers （3.2_＋0.9）, and maximal energy per deployment （16.9±3.4） W） were shorter or lower than those of the CMT group （（14.3±6.2） min, （13.6±3.5） min, 6.3±2.1, （23.7±1.3） W, respectively） （P 〈0.05）. But the operative cost for the MNS group was higher than that of the CMT group （P 〈0.01 ）. Conclusion Magnetic navigation system guided radiofrequency catheter ablation of AVNRT has the advantages of shorter fluoroscopy time and lower energy delivery numbers and maximal energy per deployment compared to the present conventional ablation technique.

A three-pulmonary vein isolation approach to treat paroxysmal atrial fibrillation

Objective To investigate the safety and efficacy of a 3-pulmonary vein (PV) isolation approach in treating paroxysmal atrial fibrillation (AF). Methods Radiofrequency catheter ablation was used to eliminate PV potential in 11 patterns with frequent paroxysmal AF refractory to anti-arrhythmic agents. During sinus rhythm, PV potential was mapped in the left and right superior PVs and left inferior PV. The procedural success was defined as the elimination of PV potential in the 3 PVs. Restults PV potential was identified and abolished in a total of 24 PVs, mostly in the left and right superior PV. There was no pulmonary stenosis or other complications during or after the procedures. AF recurred in one patient after an average of 12 ± 3 month follow-up. Conclusions PV potemials were present mostly in the left or right superior PV. The 3-PVs isolation approach is safe and effective in preventing drug-resistant paroxysmal AF.

RADIOFREQUENCY CATHETER ABLATION OF VENTRICULAR TACHYCARDIA IN 26 PATIENTS

Electrophysiology study and radiofrequency catheter ablation (RFCA) were performed in 26 patients with refractory sustained ventricular tachycardia (VT). After induction of VT, 12-lead electrocardiogram (ECG) was recorded and QRS morphology and axis of induced VT were studied to identify the origin of VT. The precise site of VT origin were localized by pace mapping and activation mapping carefully. RF energy was delivered through a big-tip deflectable electrode catheter when the earliest site of endocardial activation and a high-frequency and low-amplitude potential of Purkinje fiber, preceding surface QRS by more than 25 ms, were identified and / or a pace map was obtained showing identical QRS complexes in at least 11 of 12 ECG leads. VTs were ablated successfully in 24 of 26 patients (success rate was 92%). For successful ablation, it is essential that the pace map QRS morphology in 12 leads should be identical with that in spontaneous or induced VT as far as possible in performing pace mapping. Pace mapping is safe, simple and has no unfavourable effect on hemodynamics although it takes longer time. Activation mapping takes shorter time and has a high success rate. QRS configuration in spontaneous VT can help to localize the site of VT origin. Deliberate mapping at the site suggested to bo the origin of VT by surface ECG can shorten the duration of mapping and increase the success rate of RFCA. RFCA of VT in patients without structural heart disease is effective, safe, and has a high success rate, so it may be considered as an early therapy for these patients.

Radiofrequency ablation for treating paroxysmal supraventricular tachycardia complicated by atrial fibrillation： A single-center retrospective analysis

The effect of selective radiofrequency ablation for treating paroxysmal supraventricular tachycardia （PSVT） and its associated paroxysmal atrial fibrillation （PAF） was assessed. Methods Data were collected retrospectively from patients diagnosed of PSVT and subsequently treated with radiofrequency ablation. Regular monthly follow-up by dynamic electrocardiography （ECG） was performed. Incident rates of atrial fibrillation before and after ablation were compared. Results 382 PSVT patients with 58 having atrial fibrillation were en- rolled. The order of complicated PAF from high to low in these patients was displayed as： atrial tachycardia （AT）, atrioventricular reentrant tachycardia （AVRT） and atrioventricular nodal reentrant tachycardia （AVNRT）. Among AVRT patients, PAF was more frequent in patients having accessory pathways. AVNRT patients had significant- ly lower PAF rate comparing to other patients. PAF incident rate was significantly reduced by radiofrequency ablation therapy. Conclusion We advise regular dynamic ECG for PSVT patients, especially those with atrial flutter, AT or pre-excitation syndrome. Selective radiofrequency ablation is a feasible approach for treating AF complicated PSVT patients.

儿童特发性左室室性心动过速临床分析

目的分析并总结儿童特发性左室室性心动过速(ILVT)的临床特点及治疗效果。方法回顾性分析2010年1月—2021年4月于心血管内科住院治疗的ILVT患儿的临床资料。结果纳入31例ILVT患儿,中位首发年龄7.8(3.3~10.8)岁。男21例、女10例,首发年龄为6~18岁共18例(58.1%)。接受射频消融的患儿(手术组,14例)的首发年龄为9.4(6.7~11.7)岁,大于未接受射频消融的患儿[非手术组,17例,5.4(0.4~9.6)岁],差异有统计学意义(P<0.05)。27例室性心动过速发作无明确诱因。10例患儿以心慌、胸闷、心前区不适为主要表现。非手术组和手术组临床症状严重程度分布差异有统计学意义(P<0.05),非手术组临床表现较轻微。抗心律失常药物以维拉帕米及普罗帕酮疗效较好,复律有效率分别为100%和64.7%。射频消融手术治疗的即刻成功率100%,远期随访2例复发再次手术后恢复正常。结论ILVT多发生在学龄期,无明确诱因,临床症状不重,大多药物治疗反应好且预后良好,对于反复发作且药物疗效欠佳者可行射频消融治疗。

心脏三维电解剖标测在导管射频消融术治疗阵发性室上性心动过速患者中的应用

目的探讨心脏三维电解剖标测在导管射频消融术治疗阵发性室上性心动过速患者中的应用。方法选取2018年10月至2020年4月中国人民解放军联勤保障部队第九〇四医院诊治的阵发性室上性心动过速患者87例,根据治疗方法不同分为对照组41例和观察组46例。对照组在X线透视下完成导管射频消融术治疗,观察组在心脏三维电解剖标测系统下完成导管射频消融术治疗,术后完成6个月随访。比较两组消融成功率、手术时间、X线辐射量、并发症及复发率;对患者复发情况进行单因素分析及多因素Logistic分析。结果两组术后1、3个月复发率无统计学意义(P>0.05);观察组术后并发症发生率及术后6个月复发率均低于对照组(χ^(2)=5.002、5.002,P<0.05);观察组X线辐射剂量和辐射时间低于对照组(t=10.936、11.322,P<0.05)。87例患者6个月随访时未有患者死亡,将复发2例作为复发组,其余作为未复发组,进行单因素分析,结果显示两组手术方法差异有统计学意义(χ^(2)=7.297,P<0.05)。多因素Logistic回归分析结果显示,手术方式是患者复发的影响因素[OR(95%CI)=1.846(1.527~2.313),P<0.05]。结论在阵发性室上性心动过速患者导管射频消融术治疗中应用心脏三维电解剖标测能减少辐射剂量,术后并发症和复发率较低。

成人室上速类型与性别、年龄相关性分析

目的阵发性室上性心动过速(PSVT)在不同年龄段皆可发生,本研究旨在探讨成人PSVT类型是否与年龄、性别存在相关性。方法回顾性分析2017年1月至2022年3月因PSVT入院成年患者共726例。按手术时年龄分为四组:<20岁,20~40岁,41~60岁,>60岁;按类型分为房室结折返性心动过速(AVNRT)和房室折返性心动过速(AVRT);AVRT按位置进一步细分为左侧、右侧、心外膜三种类型旁道。结果①AVNRT较AVRT发生率高(63.1%VS.36.9%),女性AVNRT发生率是男性的1.7倍,男性AVRT发生率是女性的1.26倍;②随着年龄的增长,AVNRT发生率逐渐增高(37.9%、48.1%、61.7%、72.5%),AVRT发生率逐渐降低(62.1%、51.8%、38.3%、27.5%);③<20岁和20~40岁年龄组男性AVRT比AVNRT发生率高,41~60岁和>60岁年龄组女性AVNRT比AVRT发生率高;④41~60岁是射频消融手术的高峰年龄,占总人数51.1%。结论成人室上速类型与性别、年龄在某些方面存在一定的相关性。

食道心房调搏检查诊断阵发性室上性心动过速的价值

目的比较食道心房调搏(TEAP)与心内电生理检查(EPS)诊断阵发性室上性心动过速(PSVT)的价值,分析其影响因素。方法回顾性分析2017年1月至2022年3月因PSVT入院,完成TEAP、EPS及射频消融的患者436例。按检查前短期内[(2.17±1.63)d]是否使用过静脉抗心律失常药物,分为用药组和未用药组;PSVT按类型分为房室结双径路、左侧旁道、右侧旁道;按刺激方法分为TEAP和EPS;以最终成功消融靶点作为PSVT分型金标准。结果未用药组TEAP诱发率(72%)与用药组(56.5%)比较,差异有统计学意义(P<0.05)。TEAP对双径路、左侧旁道、右侧旁道的诱发差异有统计学意义(P<0.05);TEAP诱发率与EPS比较,差异有统计学意义(P<0.05);TEAP诊断PSVT的准确性83.9%。异丙肾上腺素可提高EPS的诱发率从76.8%至94.7%。结论TEAP是术前诊断PSVT的有效方法,静脉抗心律失常药物停用超过5个半衰期后仍对TEAP诱发有一定影响,异丙肾上腺素可提高EPS的诱发率。

特发性室性心动过速的导管射频消融治疗效果

目的评价导管射频消融（radiofrequency catheter ablation，RFCA）对特发性室速（idiopathic ventricular tachycardia，IVT）的治疗效果以及心电图对消融靶点的定位价值。方法对126例特发性室速患者的电生理资料及RFCA治疗效果进行回顾性分析。多数患者采用激动顺序标测，射频能量采用温控法（60～65℃）。结果126例患者中右室流出道（fight ventricular outtflow tract，RVOT）IVT62例、左后间隔IVT43例，其他部位IVT21例。本组RFCA的总成功率为87．3％，RVOT-IVT和左后间隔IVT的成功率显著高于其他部位IVT（96．8％和90．7％vs52．4％，P〈0．05）。本组8例患者存在发作性晕厥（发作的R-R间期230～260m8），其中4例合并房室结双径路、2例合并隐匿性房室旁道、2例合并多形性室速。随访6个月至10年，复发9例（复发率为8．2％），均再次RFCA成功。合并心动过速性心肌病者6例，术后3个月心脏大小与心功能均恢复正常。结论采用激动顺序标测法RFCA治疗IVT成功率高；室速发作时体表心电图对绝大多数室速起源具有定位价值；部分室速可能合并房室旁道或房室结双径路。

射频消融术治疗室上性心动过速1000例的疗效

目的评价射频消融术治疗阵发性室上性心动过速的安全性和有效性。 方法 10 0 0例阵发性室上性心动过速的患者接受射频消融术 ,术后平均随访 2 5± 19月 (1～ 110月 )。 结果射频消融术治疗室上性心动过速的总成功率为 98.9% (989/ 10 0 0 ) ,其中旁道参与的心动速度 5 90例 (5 98条旁道 ) ,阻断 5 88条 ,成功率 98.3% ;房室结折返性心动过速 4 10例 ,慢径消融成功率为 99.8%。 14例 (1.4 % )患者出现并发症。随访期间 ,16例 (1.6 % )患者复发 ,再次接受射频消融术均获成功。 结论射频消融术是目前治疗阵发性室上性心动过速最为有效的手段 ,其成功率高 ,并发症少 。

三维电场导航系统非透视引导下导管消融治疗阵发性室上性心动过速

目的探讨三维电场导航系统(EnSite-NavX)非X线透视引导下导管射频消融术(RFCA)治疗阵发性室上性心动过速(PSVT)的可行性。方法对42例PSVT患者,在NavX系统非X线透视引导下行RFCA。结果 42例PSVT,其中房室结折返性心动过速22例、房室折返性心动过速20例(右侧旁道4例,左侧旁道15例,左、右侧双旁道1例),全部消融成功,无严重并发症发生。前8例为验证消融靶点位置行数秒X线透视,1例患者左锁骨下-奇静脉迂曲畸形,行静脉造影,1例左前隐匿性旁道非X线透视引导下消融未成功,改在透视下消融,更换合适消融导管消融成功,X线曝光时间6 m in,其余患者手术全程在非X线透视下完成。结论 NavX非透视引导下行RFCA是可行的。