磁导航技术应用于室上性心律失常消融治疗的初步经验

目的探讨磁导航技术应用于室上性心律失常消融治疗的有效性和安全性。方法对不同类型室上性心律失常患者,在常规电生理标测的基础上,采用NiobeⅡ磁导航系统（Stereotaxis,Inc）遥控操作进行温控射频消融治疗。5例入院诊断室上性心律失常患者,男3例,女2例,平均年龄（45±18）岁。2例有器质性心脏病病史。心内电生理诊断心房扑动2例,其中1例合并房室结折返性心动过速,右后间隔显性房室旁道1例,左后游离壁隐匿性旁道1例。结果5例利用常规心内电生理标测后均采用磁导航系统遥控操作精确标测靶点并行射频消融,4例成功。操作时间（116±31）min,术者X光曝光时间仅为（4.5±1.5）min。5例患者均未发生手术并发症。结论对不同类型室上性心律失常,初步研究表明,采用磁导航技术均可安全与有效地实施遥控标测和消融治疗,并且明显降低术者的X光曝光时间。

Initial experience of remote magnetic navigation for mapping and ablating supraventricular arrhythmia

Objective To assess the effectiveness and safety of remote magnetic navigation for mapping and ablating supraventricular arrhythmia. Methods Different types of supraventricular arrhythmia patients underwent remote control mapping and ablation using the NiobeⅡmagnetic navigation system. Five patients 3 males and 2 females,mean age （45±18） years were included. Two patients had history of structural heart diseases. Cavotricuspid isthmus-dependent right atrial flutter was found in 2 patients,and 1 combined with atrioventricular nodal reentrant tachycardia. Left free wall accessory pathway was found in 2 patients,and right posterior septal accessory pathway in 1 patient. Results Based on standard electrophysiological investigation,all 5 patients were submitted to procedure with remote control manipulation for mapping and ablating supreventricular arrhythmia. The procedure was successful in 4 patients. The average procedure time was （116±31）min. Fluoroscopy time of operator was （4.5±1.5）min. No complication was observed in all 5 patients. Conclusion Remote control mapping and ablation of supraventricular tachyarrhythmia is safe and feasible using magnetic navigation technique. This technique can also decrease the fluoroscopy time of operator.