EnsiteNavX标测系统指导下环肺静脉左心房线性消融治疗心房颤动

目的 探讨EnsiteNavX标测系统指导下环肺静脉左房线性消融电隔离治疗心房颤动的疗效.方法 阵发性心房颤动14例和持续性心房颤动3例,采用EnsiteNavX标测系统进行环肺静脉左房线性消融.消融终点为肺静脉电隔离.结果 17例患者均达到消融终点;手术时间(226.1±36.2)min、X线曝光时间(41.3 ±12.8)min、放电时间(61.9±15.4)min.术后2例复发,1例再次消融成功,1例拒绝再次手术;随访3～26个月,14例(82.3%)无心房颤动发作;3例(17.7%)有心房颤动复发,但发作次数及时间均较术前明显减少,用胺碘酮治疗可控制(术前胺碘酮治疗无效).术中及随访期间无任何与操作相关的并发症.结论 Ensite NavX标测系统指导下环肺静脉左房线性消融治疗心房颤动有效、安全.

Left atrial circumferential ablation of pulmonary veins for atrial fibrillation guided by Ensite NavX mapping system.

Objective To study the feasibility, safety, effectiveness of left atrial circumferential ablation of pulmonary veins for atrial fibrillation(Af) guided by EnsiteNavX mapping system. Methods Seventeen patients with paroxysmal or persistent Af were included. Real time 3-dimensional left artial (LA) and pulmonary veins (PVs) maps were constructed through EnsiteNavX mapping system. Pulmonary veins isolation was performed by encircle the left and right sides PVs at adistance of 1 to 2 cm away from the ostium of PVs. Results Seventeen patients were all reached the endpoint of abalation completely. The mean procedure time and fluoroscopy time were (226.1 ± 36.2) minutes and (41.3 ± 12.8) minutes. Mean radiofrequency energy delivery time was (61.9 ±15.4) minutes. Recur-rence of Af occurred in two patients, one was repeat ablation succnssfully. During 3 ～ 36 months followup, fourteen patients (82.3%) were free of Af without any antiarrhythmic drugs. Recurrence of Af occurred in three(11.7%) patients treated with amiodarone. No complications occurred during the procedure and the following up. Conclusion Left atrial circumferential isolation of pulmonary veins for Af guided by Ensite NavX mapping system was effective and salty.