Carto系统与常规方法指导消融频发右室流出道室性早搏的比较

目的通过对应用Carto电解剖标测系统(Carto系统)与常规方法指导射频消融治疗频发右室流出道室性早搏(RVOT-PVCs)的比较,评价其临床应用。方法 68例频发RVOT-PVCs患者,其中Carto组36例,运用Carto系统重建右室流出道三维电解剖图后行电解剖标测靶点并予冷盐水灌注电极进行消融;另32例在X线下常规标测和消融,为常规组。比较两组的手术时间、靶点标测时间、X线曝光时间、总放电次数及有效放电率、消融成功率、并发症和随访复发结果。结果手术时间、即时成功率两组无差别(P0.05)。与常规组相比,Carto组靶点标测时间明显缩短(50.8±10.2minvs71.9±20.9min),X线曝光时间缩短(15.5±3.8minvs27.0±7.1min),总放电次数减少(5.8±1.2次vs9.4±1.8次),有效放电率增高(48.1%±12.2%vs31.5%±7.9%),复发率降低(2.8%vs9.4%),P均0.05。两组均无并发症。结论两种标测方法消融频发RVOT-PVCs均有效,安全。但Carto系统对复杂的多源多形早搏有明显的优势。

The comparison of Carto system and conventional mapping of catheter ablation for frequent premature ventricular contractions originating from the right ventricular outflow tract

Objective To assess the clinical efficacy of electroanatomieally guided mapping and radiofrequency ablation under Carto system for frequent premature ventricular contractions（PVCs） originating from the right ventricular outflow tract （RVOT） with comparison to conventional mapping method. Methods Sixty-eight patients with frequent RVOT-PVCs were enrolled into this study. 36 cases who underwent saline-irrigated catheter ablation under the guide of Carto system were assigned as the Carto group, while 32 patients who underwent conventional mapping and ablation as the control group. The procedural ,mapping and fluoroscopic time, the success rate, the number of energy application, the effective rate of energy application, the recurred rate and the complications were compared between these two groups. Results There was no significant difference with regard to the procedure time and acute success rate between the two groups. Comparing with the control group, the mapping and fluoroscopic time shortened significantly（50.8 ± 10.2 min vs 71.9 ± 20.9 min and 15.5 ± 3.8 min vs 27.0 ±7.1 min） ,the number of energy application reduced（5.8± 1.2 vs 9.4 ± 1.8） and the effective rate of energy application raised（48.1% ± 12.2% vs 31.5% ±7.9% ） ,the recurred rate reduced（2.8% vs 9.4% ） in Carto group, all P values 〈 0.05. No complications occurred. Conclusion Two mapping method are all safe and efficient for patient with frequent RVOT-PVCs. But Carto system is superior to conventional mapping in treatment of sophisticated premature. Chinese Journal of Cardiac Pacing and Electrophysiology, 2010,24 （4） ：320 -324 ]