CAJ | 학술논문

目的 Carto系统指导下对心房颤动(房颤)相关的靶肺静脉进行环同侧上、下肺静脉-前庭单环线性消融隔离,观察疗效.方法对25例术中反复自发肺静脉相关房性早搏(房早),并触发房性心动过速(房速)和/或房颤的患者,在Carto系统结合单Lasso环状标测导管指导下进行环靶肺静脉-前庭单环射频消融术,达到肺静脉隔离.结果消融过程中25例患者房早、房速、房颤终止,其中19例患者有自发的肺静脉电位,15例慢于窦性心率.4例患者隔离后肺静脉内发生房颤或房速,2例在肺静脉内补点消融后肺静脉电位消失.随访(22.24±9.01)个月,23例无房速、房颤发作,2例患者术后复发房颤,1例接受再次手术,术后房颤发作减少,1例口服胺碘酮控制.结论术中能够明确靶肺静脉、单个触发灶的房颤患者,在Carto系统结合单Lasso导管指导下行单环线性消融隔离治疗房颤,成功率高、复发率低,可减少手术损伤.
목적 Carto계통지도하대심방전동(방전)상관적파폐정맥진행배동측상、하폐정맥-전정단배선성소융격리,관찰료효.방법 대25례술중반복자발폐정맥상관방성조박(방조),병촉발방성심동과속(방속)화/혹방전적환자,재Carto계통결합단Lasso배상표측도관지도하진행배파폐정맥-전정단배사빈소융술,체도폐정맥격리.결과 소융과정중25례환자방조、방속、방전종지,기중19례환자유자발적폐정맥전위,15례만우두성심솔.4례환자격리후폐정맥내발생방전혹방속,2례재폐정맥내보점소융후폐정맥전위소실.수방(22.24±9.01)개월,23례무방속、방전발작,2례환자술후복발방전,1례접수재차수술,술후방전발작감소,1례구복알전동공제.결론 술중능구명학파폐정맥、단개촉발조적방전환자,재Carto계통결합단Lasso도관지도하행단배선성소융격리치료방전,성공솔고、복발솔저,가감소수술손상.
Objective To evaluate the effects of catheter ablation of the unilateral atrium for lone atrial fibrillation originating from pulmonary atrium guided by electro anatomical mapping (Carto) system.Methods Twenty-five cases with atrial tachycardia and/or atrial fibrillation triggered by atrial premature beats originating from pulmonary atrium were included in this study.The related unilateral pulmonary atrium was isolated by radiofrequency ablation guided by Carto system and a single lasso catheter.Results The atrial premature triggered atrial tachycardia and/or atrial fibrillation were observed during electrophysiological study.All the tachycardia and/or atrial fibrillation were eliminated by radiofrequency ablation during the procedure.There were spontaneous pulmonary vein potentials in 19 cases.The frequency in 15 of the 19 cases was lower than sinus rate.Atrial fibrillation or atrial tachycardia was observed in 4 patients after circumferential pulmonary vein isolation.The potentials were eliminated by the supplement ablation in the pulmonary vein in 2 cases.All patients were followed up for (22.24±9.01) months and no recurrence was observed in 23 patients.2 cases had tachycardia and/or atrial fibrillation recurrence,one was accepted another radiofrequency ablation,The other one took amiodarone treatment.Conclusion Catheter ablation of the unilateral atrium for lone atrial fibrillation was effective and safety.