全三维技术在老年心房颤动射频消融术中的安全性及有效性研究Evaluate the safety and efficacy of the CARTO3-based total three-dimensional mapping technique in radiofrequency catheter ablation of elderly patients with atrial fibrillation
胡宇才,白融,许丰强,李松南,郭雪原,刘念,桑才华,龙德勇,汤日波,蒋晨曦,赵欣,夏时俊,闻松男,董建增,马长生,喻荣辉
摘要(Abstract):
目的评估CARTO3为基础的全三维技术体系(T3D技术)零射线标测技术在老年心房颤动(房颤)射频消融术中应用的安全性及有效性。方法纳入2015年12月至2017年4月北京安贞医院心律失常诊疗中心诊断为阵发性房颤行射频消融治疗的患者共60例,随机分为研究组(30例)采用T3D技术;对照组(30例)行常规房颤射频消融术。比较两组患者手术相关参数、环肺静脉电隔离术(CPVI)成功率、房颤复发率、并发症发生率。结果研究组心房重建时间[(57.7±11.0)min比(10.4±3.5)min,P<0.001]显著大于对照组;而冠状窦电极到位时间显著少于对照组[(1.1±0.6)min比(2.9±1.7)min,P<0.001],差异均有统计学意义。研究组X线曝光时间为零,对照组(15.73±3.91)min,差异有统计学意义(P<0.001)。而两组射频消融时间和手术总时间比较,差异均无统计学意义(均P>0.05)。单次房间隔穿刺成功率比较,研究组高于对照组(86.7%比63.3%,P=0.037),差异有统计学意义。研究组发生2例三维解剖模型移位,而对照组无移位现象发生;研究组无房间隔穿刺困难患者,对照组则有3例房间隔穿刺困难患者。两组患者CPVI全部成功,两组患者术后早期及晚期复发率、并发症发生率比较,差异均无统计学意义(均P>0.05)。结论 T3D技术应用于老年阵发性房颤患者的射频消融治疗是安全、有效的,可减少术中X线曝光时间,具有较重要的临床应用价值。
关键词(KeyWords): 全三维;房颤;安全性;有效性
基金项目(Foundation): 首都卫生发展科研专项重点攻关项目(首发2014-1-2016);; 国家自然科学基金项目(81370291)
作者(Author): 胡宇才,白融,许丰强,李松南,郭雪原,刘念,桑才华,龙德勇,汤日波,蒋晨曦,赵欣,夏时俊,闻松男,董建增,马长生,喻荣辉
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