环单侧靶肺静脉-前庭射频消融治疗心房颤动

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.

Catheter ablation of the unilateral atrium for lone atrial fibrillation

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.