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一种基于 CartoUNIVU 模块指导的起源于心尖部室性早搏的新消融策略。

A novel ablation strategy of premature ventricular contractions originating from summit guided by CartoUNIVU module.

机构信息

Department of Cardiology, Capital Medical University, Beijing, China.

Department of Cardiovascular, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Qingdao, China.

出版信息

Clin Cardiol. 2020 Sep;43(9):963-967. doi: 10.1002/clc.23390. Epub 2020 May 19.

Abstract

BACKGROUND

Premature ventricular contractions (PVCs) from left ventricular (LV) summit remain challenging for the risk of coronary artery injury. Computed tomographic or intracardiac echocardiography may be helpful, but both still have many limitations. CartoUNIVU module has rarely been used in PVC ablation.

METHODS

A total of 22 patients (14 men: mean age 56.4 ± 13.3 years) with an electrocardiogram indication of summit PVCs were included in the two centers study. A novel strategy ablation with the Image Integration Module CartoUNIVUTM module was performed for all the patients with PVCs originating from LV summit area, especially to prevent the coronary artery injury.

RESULTS

The procedure time was 78.6 ± 22.7 minutes, and the fluoroscopy time was 12.5 ± 3.1 minutes. The distance between the target and nearest coronary artery was 8.0 ± 3.1 mm. Three patients with the distance to the nearest coronary artery <5 mm. During a mean follow-up of 11.0 ± 1.7 months, 21/22 (95.5%) patients were free from clinical PVC. No coronary artery injury was detected in the all the ablation procedures.

CONCLUSION

The novel strategy ablation with the Image Integration Module CartoUNIVU module is safe and effective for PVCs originating from LV summit area, especially to prevent the coronary artery injury.

摘要

背景

左心室(LV)顶部的室性早搏(PVCs)仍然存在冠状动脉损伤的风险,这对其治疗极具挑战性。计算机断层扫描或心内超声心动图可能会有所帮助,但这两种方法仍然存在许多局限性。CartoUNIVU 模块很少用于 PVC 消融。

方法

在两个中心的研究中,共有 22 名心电图提示顶部 PVCs 的患者(14 名男性:平均年龄 56.4±13.3 岁)被纳入研究。所有患者均采用 Image Integration Module CartoUNIVUTM 模块进行新型策略消融,特别是为了防止冠状动脉损伤。

结果

手术时间为 78.6±22.7 分钟,透视时间为 12.5±3.1 分钟。目标与最近冠状动脉之间的距离为 8.0±3.1mm。有 3 名患者最近冠状动脉距离<5mm。在平均 11.0±1.7 个月的随访中,21/22(95.5%)例患者无临床 PVC。在所有消融术中均未发现冠状动脉损伤。

结论

采用 Image Integration Module CartoUNIVU 模块的新型策略消融治疗 LV 顶部起源的 PVCs 是安全有效的,特别是可以防止冠状动脉损伤。

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