CAJ | 학술논문

目的评估心房颤动(房颤)经外科导管迷宫术后复发房性心律失常经双Lasso导管技术行肺静脉完全电隔离后的疗效.方法在三维电解剖系统指导(Carto)下结合双lasso导管同侧肺静脉标测技术下行经皮射频导管消融术完成.消融术终点:(1)明确同侧肺静脉传导的缝隙并消融致所有肺静脉电位的消失;(2)临床房性心律失常不能诱发.结果对8例经外科导管迷宫术后药物仍无法控制的症状性房颤患者进行了经皮导管射频消融术,男性4例,女性4例,年龄(62±5)岁,左心房内径(50±6)mm,病史时间(9.1±6.3)年.7例患者经双lasso导管技术证实存在肺静脉传导恢复.其中3例患者进行了2次导管消融术1例患者进行了3次导管消融术.平均随访(5.9±4.7)个月,7例患者无房颤复发.无消融术相关并发症发生.结论外科迷宫术后房性心律失常复发与术中肺静脉未完全电隔离和肺静脉传导恢复相关.三维电解剖际测系统指导下应用双lasso导管技术行同侧肺静脉完全电隔离能使大部分病例维持窦性心律.
목적 평고심방전동(방전)경외과도관미궁술후복발방성심률실상경쌍Lasso도관기술행폐정맥완전전격리후적료효.방법 재삼유전해부계통지도(Carto)하결합쌍lasso도관동측폐정맥표측기술하행경피사빈도관소융술완성.소융술종점:(1)명학동측폐정맥전도적봉극병소융치소유폐정맥전위적소실;(2)림상방성심률실상불능유발.결과 대8례경외과도관미궁술후약물잉무법공제적증상성방전환자진행료경피도관사빈소융술,남성4례,녀성4례,년령(62±5)세,좌심방내경(50±6)mm,병사시간(9.1±6.3)년.7례환자경쌍lasso도관기술증실존재폐정맥전도회복.기중3례환자진행료2차도관소융술1례환자진행료3차도관소융술.평균수방(5.9±4.7)개월,7례환자무방전복발.무소융술상관병발증발생.결론 외과미궁술후방성심률실상복발여술중폐정맥미완전전격리화폐정맥전도회복상관.삼유전해부제측계통지도하응용쌍lasso도관기술행동측폐정맥완전전격리능사대부분병례유지두성심률.
Objective To evaluate recurrence of pulmonary vein conduction in patients (pts) with recurrent atrial tachyarrhythmias (ATa) after intra-operative maze ablation and clinical follow up after accomplishing pulmonary vein (PV) isolation using the double lasso technique. Methods EP study and catheter ablation was gaided by a 3-dimensional electroanatomic mapping system (3-D EA, Carto, Biosenso Webster)combined with simultaneous ipsilateral PV mapping using the double lasso technique. Endpoints were defined as follows:1 ) identification of conduction gaps within the ipsilateral PVs, elimination of all PV spikes within the ipsilateral PVs, 2 )ablation of clinical ATas. Results Catheter ablation was performed in 8 pts [4 females, (62 ± 5 )years,LA size (50 ± 6 )mm] with drug refractory atrial tachyarrhythmia(9. 1 ± 6. 3 )years) despite catheter maze operatich. Electrical PV conduction was demonstrated in the majority of pts ( 7/8 ). All defined endpoints were a hieved. Repeat ablations were required in 3 pts(2 ablations) and in 1 pt(3 ablations) ,respectively. During a mean follow-up of(5.9 ± 4. 7 ) months,7/8 pts were free of recurrences. No procedure related complications were observed. Conclusion Incomplete lesions after intra-operative maze ablation are associated with recurrenee of pulmonary vein conduction and ATas in the majority of patients. Complete isolation of ipsilateral PVs,guided by 3-D EA mapping is feasible and successful in maintaining sinnsrhythm in the majority of patients.