EnSite标测下射频消融对特发性右室流出道室性早搏患者的疗效及心肌酶学影响

目的 探讨EnSite标测指导下射频消融治疗特发性右室流出道室性早搏的临床效果及对心肌损伤的影响.方法 回顾性分析我院2013年1月至2016年1月收治的84例右室流出道室性早搏行射频消融手术治疗患者的临床资料,对比两组患者的手术效果.结果 本组中50例患者在常规电生理标测指导下实施射频消融手术(常规组)、34例患者在EnSite标测指导下射频消融治疗(EnSite组).EnSite组患者的标测时间、射频消融时间、X线曝光时间、手术时间均显著的低于常规组,差异具有统计学意义(P＜0.05).术前,EnSite组和常规组的室性早搏数量对比,差异不具有统计学意义(P＞0.05);术后,EnSite组的24 h室性早搏数量显著低于常规组(P＜0.05);术后72 h,EnSite组的CK、CK-MB、cTnT、AST、LDH、Mb、HBDH水平显著低于常规组(P＜0.05).结论 EnSite标测指导下射频消融治疗特发性右室流出道室性早搏能显著缩短操作时间、减轻对患者心肌造成的损伤,手术效果可靠.

EnSite mapping-guided radiofrequency ablation for idiopathic ventricular premature beats originating in right ventricular outflow tract

Objective To evaluate the clinical effect of EnSite mapping-guided radiofrequency ablation for patients with idiopathic ventricular premature beats arising from right ventricular outflow tract (RVOT-VPBs) and its influence on myocardial injury.Methods The clinical data of 84 patients with RVOT-VPBs who underwent radiofrequency ablation in our hospital from January 2013 to January 2016 were retrospectively analyzed.The patients were divided into conventional treatment group (control group,n =50) who received radiofrequency ablation guided by electrophysiological mapping,and EnSite group (n =34) who were treated by EnSite mapping-guided ablation.The therapeutic effects between the two groups were compared.Results Compared with the conventional group,the duration of mapping,radiofrequency ablation,X-ray exposure and operation was significantly decreased in the EnSite group (P ＜ 0.05).Preoperationally,there was no statistically significant difference in PVBs between the 2 groups.After the operation,the PVBs in the EnSite group was significantly lower than in the conventional group at 24 h (P ＜0.05).Parameters including creatine kinase (CK),creatine kinase isoenzyme MB (CK-MB),cardiac Troponin T (cTnT),aspartate aminotransferase (AST),lactate dehydrogenase (LDH),Mb and hydroxybutyrate dehydrogenase (HBDH) were significantly lower in the EnSite versus conventional group at 72 h (P ＜ 0.05).Conclusion EnSite mapping-guided radiofrequency ablation remarkably decreases the operation time and alleviate the myocardial injury,which is beneficial for patients with RVOT-VPBs.