应用三维磁导航系统标测和消融快速性心律失常的初步经验

目的观察三维磁导航系统标测和消融快速性心律失常的疗效。方法结合NiobeII磁导航系统和CARTO-RMT电解剖标测系统,采用4mm-顶端的NaviStar-RMT标测和消融导管进行射频消融治疗快速性心律失常。结果10例患者,男6例,女4例。房室结折返性心动过速4例,其中1例合并阵发性心房颤动,左侧房室旁道2例,右侧房室旁道1例,典型心房扑动2例,右室流出道室性心动过速1例。磁导航系统遥控操作,10例均完成电生理标测。9例消融成功,失败1例为心房扑动患者,换用NaviStar盐水灌注导管后消融成功。导管操作时间93±33.1min,X线曝光时间12.5±6.5min。随访6个月无复发。结论对于快速性心律失常,应用磁导航系统可进行有效和安全的三维标测和消融。

Initial experience of three-dimension remote-guided magnetic catheter navigation system in mapping and ablation of tachycardia

Objective To investigate the effect of three-dimension remote-guided magnetic catheter navigation system in mapping and ablation of tachycardia. Methods CARTO-RMT electroanatomical mapping system was integrated with Niobe Ⅱ magnetic catheter navigation system, a 4mm-tip NaviStar-RMT mapping and ablation catheter was performed to ablate. Results Ten patients were enrolled,including 6 female and 4 male. After electrophysiological examination, atrioventricular nodal reentrant tachycardia was found in 4 patients, and one of them was accompanied with paroxymal atrial fibrillation, left accessory pathways was found in 2 patients, right accessory pathway was found in 1 patient, typical atrial flutter was found in 2 patients, ventricular tachycardia originated from right ventricular outflow tract was found in 1 patient. Ablation was successful in 9 patients, and failed in 1 patient, the failed case was a patient with atrial flutter, but successed after replacement of a NaviStar irrigating catheter. The average procedure time was 93 ± 33.1 min, the total X-ray exposure time was 12.5 ±6.5 min. No recurrence was found in follow-up of 6 months. Conclusion Applying three-dimension remote-guided magnetic catheter navigation system in mapping and ablation of tachycardia is effective and safe.