CAJ | 학술논문

目的对主动脉窦起源的室性心律失常进行标测和消融需要准确和安全.本研究尝试采用EnSite NavX标测技术对起源于主动脉窦的室性心动过速(室速)和/或室性早搏(室早)进行消融.方法运用NavX标测系统构建主动脉窦、升主动脉及冠状动脉开口的三维电解剖及激动顺序图,同时进行冠状动脉造影,以确认NavX导航的准确性.结合传统的电生理标测,射频消融治疗24例主动脉窦起源的室早和/或室速.结果 2例均射频消融成功,其中,左冠窦内起源16例,右冠窦内起源4例,左、右冠窦间起源4例,术中和术后无并发症.消融时间及X线曝光时间(包括冠状动脉造影时间)分别为(56.1±18.3)min、( 11.2±6.8)min.1例患者消融前发现合并左旋支中段狭窄,消融术后成功行支架术.平均随访(16±12)个月,1例室速患者有室早复发,再次消融成功.结论 NavX标测技术可以代替冠状动脉造影,指导主动脉窦起源的室早和/或室速的标测和消融.
목적 대주동맥두기원적실성심률실상진행표측화소융수요준학화안전.본연구상시채용EnSite NavX표측기술대기원우주동맥두적실성심동과속(실속)화/혹실성조박(실조)진행소융.방법 운용NavX표측계통구건주동맥두、승주동맥급관상동맥개구적삼유전해부급격동순서도,동시진행관상동맥조영,이학인NavX도항적준학성.결합전통적전생리표측,사빈소융치료24례주동맥두기원적실조화/혹실속.결과 2례균사빈소융성공,기중,좌관두내기원16례,우관두내기원4례,좌、우관두간기원4례,술중화술후무병발증.소융시간급X선폭광시간(포괄관상동맥조영시간)분별위(56.1±18.3)min、( 11.2±6.8)min.1례환자소융전발현합병좌선지중단협착,소융술후성공행지가술.평균수방(16±12)개월,1례실속환자유실조복발,재차소융성공.결론 NavX표측기술가이대체관상동맥조영,지도주동맥두기원적실조화/혹실속적표측화소융.
Objective To study the feasibility and safety of radiofrequency catheter ablation(RFCA)of ventricular tachycardia(VT)or ventricular premature contraction(VPC)originating from the aortic cusp underthe guidance of EnSite NavX system.Methods Twenty-four patients with VT/VPC orginating from aortic cusp were enrolled.The gemetry of aortic cusp was reconstructed using NavX mapping techuique and the accuracy was confirmed by coronary angiography.Ablation was applied at the site with earliest activation Results The VTs/PVCs in all 24 crees were successfully ablatedand the targets were located on left coronary cusp in 16,right coronary cusp in 4,anterior wall of aortic between left and right coronary cusp in 4.There was no procedure-related complication occurred.The total procedure time was(56.1±18.3) min,and the fluoroscopic time (coronary angiography time included)was(11.2±6.8)min.Left circumflex artery stensis was documented before mpping in 1 case and stenting procedure was performed after RFCA There was only one VT case with PVC recurrence during a (16±12)months follow-up,and re-ablation succeeded.Comcclusion NavX mapping and navigation technique is feasible and safe to guide theablation of VT/VPC with aortic cusp origin.