CAJ | 학술논문

目的：比较希氏束旁道CARTO3及常规X光指导下标测及消融方法。方法纳入12例希氏束旁道并进行射频消融治疗的患者。入选患者均进行了心内电生理检查，9例患者行常规X光透视下标测消融靶点并进行消融，3例患者应用CARTO3三维标测系统指导靶点标测及射频消融。对不同标测方法手术成功率、X线曝光时间及并发症进行比较。结果9例常规标X光测患者中成功6例（66.7%），2例未成功，1例靶点距离希氏束过近，放弃消融，术中1例患者出现一过性完全性房室传导阻滞，X线曝光时间（36.2±13.4） min；CARTO3指导3例均成功（100.0%），X线曝光时间（14.2±7.8）min。与常规X光测患者比较，CARTO3三维标测系统指导靶点消融成功率更高，X线曝光时间更短，差异有统计学意义（P＜0.05）。结论与常规X光相比，CARTO3指导希氏束旁旁道消融可更精确指示希氏束及消融导管空间位置，缩短X光曝光时间，提高消融成功率。
목적：비교희씨속방도CARTO3급상규X광지도하표측급소융방법。방법납입12례희씨속방도병진행사빈소융치료적환자。입선환자균진행료심내전생리검사，9례환자행상규X광투시하표측소융파점병진행소융，3례환자응용CARTO3삼유표측계통지도파점표측급사빈소융。대불동표측방법수술성공솔、X선폭광시간급병발증진행비교。결과9례상규표X광측환자중성공6례（66.7%），2례미성공，1례파점거리희씨속과근，방기소융，술중1례환자출현일과성완전성방실전도조체，X선폭광시간（36.2±13.4） min；CARTO3지도3례균성공（100.0%），X선폭광시간（14.2±7.8）min。여상규X광측환자비교，CARTO3삼유표측계통지도파점소융성공솔경고，X선폭광시간경단，차이유통계학의의（P＜0.05）。결론여상규X광상비，CARTO3지도희씨속방방도소융가경정학지시희씨속급소융도관공간위치，축단X광폭광시간，제고소융성공솔。
Objective To compare mapping and radiofrequency ablation (RFA) of para-His bundle atrioventricular accessory pathways guided by CARTO3 system or routine X-ray. Methods The patients (n=12) with para-His bundle atrioventricular accessory pathways treated with RFA were chosen and given intracardiac electrophysiological examinations. The target of RFA was mapped with routine X-ray in 9 patients and with CARTO3 system in 3 ones, and then all patients were given treatment of RFA. The success rate of RFA, time of X-ray exposure and complications were compared between 2 methods. Results Among 9 patients with routine X-ray mapping, 6 had successful RFA (66.7%), 2 had unsuccessful RFA and 1 abandoned RFA because of target being too near to para-His bundle atrioventricular accessory pathways. There was 1 patient had complete atrioventricular block during RFA, and the time of X-ray exposure was (36.2±13.4) min. All 3 patients with CARTO3 system mapping had successful RFA (100.0%) and the time of X-ray exposure was (14.2±7.8) min. Compared with routine X-ray mapping, CARTO3 system mapping had higher success rate and shorter time of X-ray exposure (P<0.05). Conclusion Compared with routine X-ray, CARTO3 system can more accurately indicate the spatial locations of para-His bundle atrioventricular accessory pathways and ablation catheter, shorten time of X-ray exposure, and improve success rate of RFA.