【摘要】 目的评价Carto三维标测系统联合单根Lasso电极指导心房颤动(简称房颤)导管射频消融的效果。方法4例阵发性房颤患者,其中1例伴阵发性房扑,3例男性、1例女性,年龄(52±10)岁,房颤发作期限(3.3±1.8)年。术前心脏CT成像,术中运用Carto系统重建左房三维结构,并指导导管标测和消融;以冷肝素盐水灌注导管,行环肺静脉消融和左房顶部的线性消融术,消融完毕后,如患者仍显示为房颤,遂给予心律平70mg静脉注射,未见房颤复律,再给予100J行同步电复律。术后随访观察。结果4例均消融成功,平均消融导管射频消融(43±6)min,曝光时间为(48±7)min,未发生心脏穿孔和肺静脉狭窄等严重并发症,随访4~12个月无复发病例。结论联合应用Carto三维标测系统和单根Lasso电极指导进行房颤导管射频消融安全有效,使用单根Lasso电极较使用双根Lasso电极可以显著降低消融成本。更多还原

【Abstract】 Objective To assess the safety and effect of electroanatomical systems (Carto) guided circumferential pulmonary veins ablation for atrial fibrillation (AF).Methods Four patients with AF, one with paroxysmal atrial flutter, were studied.The mean age was (52±10) years. Three were male and one female. The mean AF duration was(3.3±1.8)years. Electroanatomical mapping was integrated with pre-acquired CT to guide catheter ablation. A 3D electroanatomical map of the left atrium including the pulmonary veins ostia was constructed with a nonfluoroscopic navigation system (Carto, Biosense Webster).All patients underwent circumferential pulmonary vein ablation. Cardioversion was done by means of drugs (Propafenone) or electrical shocks if AF persisted after ablation. Oral anticoagulant therapy lasted for 2 months after the procedure. Patients were followed up for 4-12 months.Results All patients with AF were AF-free. The radiofrequency ablation time was (6±43) min and the exposure time was (48±7) min. No serious complication or recurrence was found during the follow-up.Conclusion Carto systems united with single Lasso can be effective and safe in the guidance of the ablation for AF.Comparing with conventional approach, it reduces X-ray exposure and the cost.更多还原