Huang Xingfu, Chen Yanjia, Huang Zheng, He Liwei, Liu Shenrong, Deng Xiaojiang, Wang Yongsheng, Li Rucheng, Xu Dingli, Peng Jian
Department of Cardiology Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou The Second People's Hospital of Jiedong District, Jieyang Guangning County People's Hospital, Zhaoqing, Guangdong Province, China.
Medicine (Baltimore). 2018 Jun;97(25):e11044. doi: 10.1097/MD.0000000000011044.
Several studies have reported the efficacy of a zero-fluoroscopy approach for catheter radiofrequency ablation of arrhythmias in a digital subtraction angiography (DSA) room. However, no reports are available on the ablation of arrhythmias in the absence of DSA in the operating room. To investigate the efficacy and safety of catheter radiofrequency ablation for arrhythmias under the guidance of a Carto 3 three-dimensional (3D) mapping system in an operating room without DSA. Patients were enrolled according to the type of arrhythmia. The Carto 3 mapping system was used to reconstruct heart models and guide the electrophysiologic examination, mapping, and ablation. The total procedure, reconstruction, electrophysiologic examination, and mapping times were recorded. Furthermore, immediate success rates and complications were also recorded. A total of 20 patients were enrolled, including 12 males. The average age was 51.3 ± 17.2 (19-76) years. Nine cases of atrioventricular nodal re-entrant tachycardia, 7 cases of frequent ventricular premature contractions, 3 cases of Wolff-Parkinson-White syndrome, and 1 case of typical atrial flutter were included. All arrhythmias were successfully ablated. The procedure time was 127.0 ± 21.0 (99-177) minutes, the reconstruction time was 6.5 ± 2.9 (3-14) minutes, the electrophysiologic study time was 10.4 ± 3.4 (6-20) minutes, and the mapping time was 11.7 ± 8.3 (3-36) minutes. No complications occurred. Radiofrequency ablation of arrhythmias without DSA is effective and feasible under the guidance of the Carto 3 mapping system. However, the electrophysiology physician must have sufficient experience, and related emergency measures must be present to ensure safety.
多项研究报告了在数字减影血管造影（DSA）室中采用零荧光透视方法进行心律失常导管射频消融的疗效。然而，关于在手术室中无DSA情况下进行心律失常消融的报道尚无。为了研究在无DSA的手术室中，在Carto 3三维（3D）标测系统引导下进行心律失常导管射频消融的疗效和安全性。根据心律失常类型纳入患者。使用Carto 3标测系统重建心脏模型并指导电生理检查、标测和消融。记录整个手术过程、重建、电生理检查和标测时间。此外，还记录即刻成功率和并发症。共纳入20例患者，其中男性12例。平均年龄为51.3±17.2（19 - 76）岁。包括9例房室结折返性心动过速、7例频发室性早搏、3例预激综合征和1例典型心房扑动。所有心律失常均成功消融。手术时间为127.0±21.0（99 - 177）分钟，重建时间为6.5±2.9（3 - 14）分钟，电生理研究时间为10.4±3.4（6 - 20）分钟，标测时间为11.7±8.3（3 - 36）分钟。未发生并发症。在Carto 3标测系统引导下，无DSA进行心律失常射频消融是有效且可行的。然而，电生理医生必须有足够的经验，且必须具备相关应急措施以确保安全。
