中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2014年
2期
123-126
,共4页
翟立上%杨兵%孙建辉%徐东杰%张凤祥%居维竹%陈红武%郦明芳%杨刚%顾凯%陈明龙%曹克将
翟立上%楊兵%孫建輝%徐東傑%張鳳祥%居維竹%陳紅武%酈明芳%楊剛%顧凱%陳明龍%曹剋將
적립상%양병%손건휘%서동걸%장봉상%거유죽%진홍무%역명방%양강%고개%진명룡%조극장
磁导航系统%非接触标测系统%射频导管消融%右心室流出道%室性心动过速%室性早搏
磁導航繫統%非接觸標測繫統%射頻導管消融%右心室流齣道%室性心動過速%室性早搏
자도항계통%비접촉표측계통%사빈도관소융%우심실류출도%실성심동과속%실성조박
Magnetic navigation system%Non-contact mapping system%Radiofrequency catheter abla-tion%Right ventricular outflow tract%Ventricular tachycardia%Premature ventricular complexes
目的：探讨应用磁导航遥控导管消融治疗右心室流出道起源的室性心动过速/室性早搏( RVOT-VT/PVCs)的安全性和有效性。方法2008年11月至2009年11月,在南京医科大学第一附属医院心血管内科行体表心电图检查,诊断为RVOT-VT/PVCs的患者共16例[女12例,男4例,平均年龄(44±15)岁],结合应用非接触标测系统和起搏标测确定靶点,磁导航遥控磁导管实施消融术,消融失败者改为手控导管消融。结果10例(63%)患者使用磁导航消融成功,6例需手控导管消融,1例术后出现动静脉瘘。平均放电(3．9±1．6)次,放电时间(240±33) s,总手术时间为(190±42) min,总X线曝光时间为(4．8±2．6) min,术者X线曝光时间平均为(3．2±2．0) min,磁导航系统遥控导管X线曝光时间为(1．6±1．0) min。结论应用磁导航系统结合非接触标测系统可安全、有效地实施遥控导管消融治疗RVOT-VT/PVCs,并可减少术者和患者的X线曝光时间。
目的：探討應用磁導航遙控導管消融治療右心室流齣道起源的室性心動過速/室性早搏( RVOT-VT/PVCs)的安全性和有效性。方法2008年11月至2009年11月,在南京醫科大學第一附屬醫院心血管內科行體錶心電圖檢查,診斷為RVOT-VT/PVCs的患者共16例[女12例,男4例,平均年齡(44±15)歲],結閤應用非接觸標測繫統和起搏標測確定靶點,磁導航遙控磁導管實施消融術,消融失敗者改為手控導管消融。結果10例(63%)患者使用磁導航消融成功,6例需手控導管消融,1例術後齣現動靜脈瘺。平均放電(3．9±1．6)次,放電時間(240±33) s,總手術時間為(190±42) min,總X線曝光時間為(4．8±2．6) min,術者X線曝光時間平均為(3．2±2．0) min,磁導航繫統遙控導管X線曝光時間為(1．6±1．0) min。結論應用磁導航繫統結閤非接觸標測繫統可安全、有效地實施遙控導管消融治療RVOT-VT/PVCs,併可減少術者和患者的X線曝光時間。
목적：탐토응용자도항요공도관소융치료우심실류출도기원적실성심동과속/실성조박( RVOT-VT/PVCs)적안전성화유효성。방법2008년11월지2009년11월,재남경의과대학제일부속의원심혈관내과행체표심전도검사,진단위RVOT-VT/PVCs적환자공16례[녀12례,남4례,평균년령(44±15)세],결합응용비접촉표측계통화기박표측학정파점,자도항요공자도관실시소융술,소융실패자개위수공도관소융。결과10례(63%)환자사용자도항소융성공,6례수수공도관소융,1례술후출현동정맥루。평균방전(3．9±1．6)차,방전시간(240±33) s,총수술시간위(190±42) min,총X선폭광시간위(4．8±2．6) min,술자X선폭광시간평균위(3．2±2．0) min,자도항계통요공도관X선폭광시간위(1．6±1．0) min。결론응용자도항계통결합비접촉표측계통가안전、유효지실시요공도관소융치료RVOT-VT/PVCs,병가감소술자화환자적X선폭광시간。
Objective To evaluate the safety and efficacy of remote radiofrequency catheter ablation of right ventricular outflow tract ventricular tachycardia/premature ventricular complexes ( RVOT-VT/PVCs ) using the magnetic navigation system combined with the non-contact mapping system. Methods Totally 16 pa-tients with RVOT-VT/PVCs [12 women and 4 men,mean aged (44±15) years] were enrolled. The original site of arrhythmias was determined by non-contact activation mapping and conventional pace mapping. Ablation was performed using HeliosⅡmagnetic temperature-controled catheter manipulated by NiobeⅡmagnetic navi-gation system. If failed with magnetic system,the procedure would be transferred to manually controlled session. Results Among 10 of 16 subjects,documented RVOT-VT/PVCs were successfully abolished by remote abla-tion controlled by magnetic navigation system. In the other 6 patients,RVOT VT/PVCs were eliminated by man-ually controlled catheter ablation. The total procedure time was (190±42) min,and the mean ablation time was (240±33) s,and the average times of energy application were 3. 9±1. 6. The total X-ray exposure time was (4. 8±2. 6) min,which including (3. 2±2. 0) min for operators,and (1. 6±1. 0) min for remote ablation,respec-tively. No other complications were observed except one patient developed postoperative arteriovenous fistula. Conclusion Magnetic navigation system combined with non-contact mapping system was safe and effective for remote radiofrequency catheter ablation of RVOT-VT/PVCs. It may potentially reduce X-ray exposure time for both patients and operators.
