磁导航系统在房室结折返性心动过速导管射频消融中的应用
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全军"十一五"科研基金资助项目(项目编号:424121CK)


Radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia guided by magnetic navigation system
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    摘要:

    目的评价磁导航系统对房室结折返性心动过速导管射频消融的指导作用。方法将经过心内电生理检查确诊的房室结折返性心动过速患者随机分为两组,A组采用常规技术和4mm温控导管消融,B组采用磁导航系统和温控磁大头导管消融。两组各入选10例患者,其年龄、性别、心动过速病史和基础心血管疾病具有可比性。比较两组患者如下参数:消融操作时间、患者透视时间、术者透视时间、放电次数、消融能量、成功率、并发症、手术费用。结果两组患者全部一次消融成功,无并发症,术后住院时间相同,随访(7.1±1.4)个月,无心动过速复发。磁导航消融组的操作时间、患者和术者透视时间、放电次数和实际消融能量均明显低于常规消融组,但手术费用高于常规消融组。结论采用磁导航系统指导房室结慢径路导管射频消融能明显缩短消融操作时间及患者和术者的透视时间,减少放电次数,降低实际消融能量。

    Abstract:

    Objective To evaluate the guiding role of magnetic navigation system (MNS) in the radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT). Methods Patients with AVNRT diagnosed by electrophysiological examination were randomized into two groups. Ten patients were enrolled to each group respectively. The patients’ age,gender,tachycardia history and basic cardiovascular diseases were matched between two groups. Conventional 4mm tip temperature controlled ablation catheter was used in routine technique procedure (RTP) group and magnetic navigated temperature controlled ablation catheter was used in MNS group. Following parameters were obtained and compared between the two groups: ablation time,patient fluoroscopy time,operator fluoroscopy time,delivery times,ablation energy,success rate,complication rate and operation cost. Results The procedures were successful in all patients,and no complication was reported. No tachycardia recurred during (7.1±1.4)months follow-up. In MNS group,ablation time,patient and operator fluoroscopy time,delivery times and ablation energy were lower than those in RTP group,but operation cost was higher than that in MNS group. Conclusion MNS guided radiofrequecy catheter ablation of AVNRT has the advantages of shorter ablation and fluoroscopy time,lower delivery times and ablation energy compared to the current routine ablation technique.

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卢才义 高磊 颜伟 薛桥 张玉霄 周圣华 刘鹏 翟金月 李丽君 陈瑞.磁导航系统在房室结折返性心动过速导管射频消融中的应用[J].中华老年多器官疾病杂志,2009,8(6):498~502

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