CAJ | 학술논문

目的：探讨旋转造影重建左心房与肺静脉立体影像，嵌入实时X线透视系统指导心房颤动导管消融治疗的安全性及有效性。 　　方法：2011-04至2013-04连续入选心房颤动行射频消融治疗的患者60例，随机分为治疗组与对照组,两组患者均用三维CARTO系统进行标测，治疗组（30例）：术中用西门子ARTIS Zeego数字剪影系统行左心房及肺静脉旋转造影后，重建其立体影像并导入实时X线透视系统，作为心房颤动消融过程中标测与消融电极的路标指导消融。对照组（30例）：常规左右肺静脉造影指导消融。分别记录两组手术操作时间，X线透视时间，成功率及并发症发生率。 　　结果：60例入选心房颤动患者均顺利完成了心房颤动的消融治疗，治疗组手术操作时间及X线透视时间均明显低于对照组，差异有统计学意义（P<0.05）。两组成功率及并发症的发生率无明显差异。 　　结论：旋转造影重建左心房与肺静脉立体影像，嵌入实时X线透视系统指导心房颤动的消融治疗是安全、有效的，可减少术中X线曝光量及手术操作时间，对心房颤动的射频消融具有重要的指导意义。
목적：탐토선전조영중건좌심방여폐정맥입체영상，감입실시X선투시계통지도심방전동도관소융치료적안전성급유효성。 　　방법：2011-04지2013-04련속입선심방전동행사빈소융치료적환자60례，수궤분위치료조여대조조,량조환자균용삼유CARTO계통진행표측，치료조（30례）：술중용서문자ARTIS Zeego수자전영계통행좌심방급폐정맥선전조영후，중건기입체영상병도입실시X선투시계통，작위심방전동소융과정중표측여소융전겁적로표지도소융。대조조（30례）：상규좌우폐정맥조영지도소융。분별기록량조수술조작시간，X선투시시간，성공솔급병발증발생솔。 　　결과：60례입선심방전동환자균순리완성료심방전동적소융치료，치료조수술조작시간급X선투시시간균명현저우대조조，차이유통계학의의（P<0.05）。량조성공솔급병발증적발생솔무명현차이。 　　결론：선전조영중건좌심방여폐정맥입체영상，감입실시X선투시계통지도심방전동적소융치료시안전、유효적，가감소술중X선폭광량급수술조작시간，대심방전동적사빈소융구유중요적지도의의。
Objective: To investigate the safety and effectiveness of three-dimensional (3-D) rotational angiography reconstruction of left atrial and pulmonary vein stereo image embedded with real-time X-ray fluoroscopy system for guiding radiofrequency catheter ablation (RFCA) in treating the patients with atrial ifbrillation (AF). Methods: A total of 60 consecutive AF patients who received RFCA in our hospital from 2011-04 to 2013-04 were studied. The patients were randomly divided into 2 groups and 3-D Carto3 mapping system was applied for guiding RFCA in both groups. n=30 in each group. Treatment group, the patients received Siemens ARTIS Zeego digital subtraction system for left atrial and pulmonary vein rotational angiography, then, stereo images were reconstructed and embedded with real-time X-ray lfuoroscopy for RFCA guidance. Control group, conventional left and right pulmonary venography was conducted for RFCA guidance. The procedural and X-ray exposure times, rates of success and complications were recorded and compared between 2 groups. Results: All 60 patients had successful RFCA, compared with Control group, the patients in Treatment group had obviously less procedural time and X-ray exposure time, while the success rate and complications were similar between 2 groups. Conclusion: 3-D rotational angiography reconstruction of left atrial and pulmonary vein stereo image embedded with real-time X-ray lfuoroscopy system is safe and effective for guiding RFCA in treating the AF patients, which may reduce the procedural and X-ray exposure times.