Carto3三维电生理标测在阵发性室上性心动过速射频消融术中应用的初步研究

目的 评估Carto3三维电生理标测系统导引下施行阵发性室上性心动过速(PSVT)射频消融(RFA)术的可行性、有效性及安全性.方法 回顾性收集2015年3月至2016年2月接受Cano3三维电生理标测系统导引下RFA治疗的28例PSVT患者(Carto组),2014年3月至2015年2月接受X线导引下RFA治疗的36例PSVT患者(X线对照组),对比两组术中X线辐射时间、手术成功率、手术时间、并发症及复发率等差异.结果 Carto组术中X线辐射时间(2.6±2.3) min,显著低于X线组(15.8±9.5) min(P＜0.001),其中8例房室结折返性心动过速(AVNRT)患者零X线辐射.Carto组、X线组手术功率分别为28/28(100％)、35/36 (94.4％) (P＞0.05),手术时间分别为(162.7±34.4) min、(149.4±46,2) min(P＞0.05).Carto组无并发症发生,X线组1例AVNRT患者消融中出现一过性Ⅱ°房室传导阻滞.随访6个月,两组均无复发患者.结论 Carto3三维电生理标测系统导引下PSVT RFA安全有效,显著降低X线辐射时间,部分AVNRT患者可实现零X线辐射,不增加手术时间及手术风险.

Application of Carto3 three-dimensional electrophysiological mapping system in guiding radiofrequency ablation for paroxysmal supraventricular tachycardia: preliminary results

Objective To evaluate the feasibility,effectiveness and safety of Carto3 three-dimensional electrophysiological mapping system in guiding radiofrequency ablation (RFA) for paroxysmal supraventricular tachycardia (PSVT).Methods The clinical data of a total of 28 patients with PSVT (Carto group),who received RFA guided by Carto3 three-dimensional electrophysiological mapping system during the period from March 2015 to February 2016,were retrospectively collected.Other 36 parents with PSVT,who received fluoroscopy-guided RFA during the period from March 2014 to February 2015,were collected as control group.The X-ray irradiation time,success rate of operation,operation time,complication and recurrence rate were calculated and the results were compared between the two groups.Results The mean fluoroscopy time in Carto group was (2.6±2.3) min,which was significantly less than (15.8±9.5) min in the control group (P＜0.001),and among them zero X-ray irradiation was obtained in 8 patients who had atrioventricular nodal reentrant tachycardia (AVNRT).The operation success rates of Carto group and the control group were 100％ (28/28) and 94.4％ (35/36) respectively (P＞0.05).The operation time in Carto group and the control group was (162.7±34.4) min and (149.4±46.2) min respectively (P＞0.05).In Carto group no any complications occurred,and in the control group one patient with AVNRT developed transient degree Ⅱ atrioventricular block during ablation process.All patients were followed up for 6 months,and no recurrence was observed in all patients of both groups.Conclusion For the treatment of PSVT,RFA guided by Carto3 three-dimensional electrophysiological mapping system is safe and effective,it can significantly reduce the X-ray irradiation time,even zero X-ray radiation in some AVNRT patients,meanwhile,this technique does not increase operation time and operation risk.