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[Carto Univu电解剖标测系统指导下阵发性室上性心动过速的消融]

[Ablation of paroxysmal supraventricular tachycardia guided by Carto Univu electroanatomic mapping system].

作者信息

Zhou Ye, Jiang Hai, Hou Xiaofeng, Li Kebei, Hu Zhibin, Zou Jiangang

机构信息

Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029; Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang Jiangsu 212000, China.

Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2018 Jun 28;43(6):604-609. doi: 10.11817/j.issn.1672-7347.2018.06.005.

Abstract

To explore the safety and efficacy for radiofrequency ablation of paroxysmal supraventricular tachycardia (PSVT) guided by Carto Univu three-dimensional mapping system.
 Methods: A total of 99 patients with PSVT underwent radiofrequency catheter ablation (RFCA) were assigned to a Carto Univu group (51 patients) and a two-dimensional X-ray group (48 patients) according to the mapping method. The operation time, X-ray exposure time, X-ray exposure dose, dose area product (DAP), operation success rate and complication rate were compared between the two groups.
 Results: The Carto Univu group and the two-dimensional X-ray group were not significant difference in the operation time, the X-ray exposure time of placing catheter, the X-ray DAP of placing catheter, the number of discharge, the discharge power, and the total discharge time (P>0.05). The mapping and ablation time, total exposure time, mapping and ablation DAP and total DAP in the Carto Univu group were significantly lower than those in the two-dimensional X-ray group (P<0.01). In the right accessory pathway cases, the mapping and ablation DAP and the total DAP in the Carto Univu group decreased compared with X-ray group (P<0.05), but it decreased more profound (P<0.01) in the left accessory pathway cases and the dual atrioventricular nodal pathways cases. Seven cases in the Carto Univu group achieved "zero X-ray", including 5 cases of the dual atrioventricular nodal pathways and 2 cases of the left accessory pathway. The immediate success rate for the two groups was 100%. After 3-12 months of follow-up, there was no recurrence in the Carto Univu group but 3 suspected recurrences in the two-dimensional X-ray group. In addition, no complications occurred in the two groups. 
 Conclusion: Carto Univu electroanatomic mapping system can guide PSVT safely and effectively during radiofrequency ablation and reduce radiation exposure to both doctors and patients. It is especially suitable for dual atrioventricular nodal pathways, which may even achieve "zero X-ray". Perhaps Carto Univu will be the first choice for RFCA of dual atrioventricular nodal pathways.

摘要

探讨Carto Univu三维标测系统指导下射频消融治疗阵发性室上性心动过速(PSVT)的安全性和有效性。方法:将99例行射频导管消融(RFCA)的PSVT患者按标测方法分为Carto Univu组(51例)和二维X线组(48例)。比较两组的手术时间、X线曝光时间、X线曝光剂量、剂量面积乘积(DAP)、手术成功率及并发症发生率。结果:Carto Univu组与二维X线组在手术时间、放置导管的X线曝光时间、放置导管的X线DAP、放电次数、放电功率及总放电时间方面差异无统计学意义(P>0.05)。Carto Univu组的标测与消融时间、总曝光时间、标测与消融DAP及总DAP均显著低于二维X线组(P<0.01)。在右侧旁路病例中,Carto Univu组的标测与消融DAP及总DAP较X线组降低(P<0.05),但在左侧旁路病例和房室结双径路病例中降低更显著(P<0.01)。Carto Univu组有7例实现“零X线”,其中房室结双径路5例,左侧旁路2例。两组即刻成功率均为100%。随访3 - 12个月,Carto Univu组无复发,二维X线组有3例疑似复发。此外,两组均未发生并发症。结论:Carto Univu电解剖标测系统可安全、有效地指导PSVT射频消融治疗,减少医患双方的辐射暴露。尤其适用于房室结双径路,甚至可实现“零X线”。或许Carto Univu将成为房室结双径路RFCA的首选。

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