三维电场航系统非透视引导下导管消融术治疗阵发性室上性心动 过速.pdfVIP

三维电场导航系统非透视引导下导管消融术治疗阵发性室上性心动 过速 浙江省人民医院 屈百鸣 钱琳艳 车贤达 俞坚武 洪银维 徐 强 摘要：目的：探讨三维电场导航系统（NavX ）非透视引导下导管消融术（RFCA ） 治疗阵发性室上性心动过（PSVT ）速的可行性。方法：对52 例PSVT 患者，在 NavX 系统非透视引导下行RFCA 。结果：52 例PSVT ，其中房室结折返性心动 过速(AVNRT) 25 例、房室折返性心动过速(AVRT)27 例(右侧旁道12 例，左侧旁 道15 例，左、右侧双旁道1 例) ，全部消融成功，无严重并发症发生。前8 例为 验证消融靶点位置行数秒X 线透视，1 例患者左锁骨下-奇静脉迂曲畸形，行静 脉造影，2 例左前隐匿性旁道和1 例右游离壁隐匿性旁道非透视引导下消融未成 功，改在 X 透视下消融成功，其余患者手术全程在非透视下完成，手术时间 90-330min，平均 108.8±33.7min。结论： 在经验丰富的电生理中心 NavX 非透 视引导下RFCA 是可行的。多数患者手术全程可在非透视下完成。 关键词：导管消融术 阵发性室上性心动过速 三维电场导航系统 X 线 Nonfluoroscopic Catheter Ablation for Paroxysmal Supraventricular Tachycardia Guided By Tri-dimensional electronic navigation system Department of cardiology, Zhejiang provincial people’s hospital Qu bai-ming Qian lin-yan Che xian-da Yu jian-wu Hong yin-wei Xu qiang [ABSTRACT] Objective: To assess the feasibility of nonfluoroscopic radiofrequency catheter ablation (RFCA) for paroxysmal supraventricular tachycardia (PSVT) guided by tri-dimensional electronic navigation system (NavX). Method: 52 patients treated by RFCA with NavX, which consist of 25 AVNRT and 27 AVRT. Result: All patients were successful without serious complications. Initial 8 cases of patients using of fluoroscopy were required to validate the location of ablation, 1 case had to radiography because of deformation of left sub-clavicle vein, 1 case of left AVRT and 1 case was of right AVRT finally ablated with X-ray fluoroscopy, the other patients had 0 fluoroscopy. Conclusions: nonfluoroscopic RFCA for PSVT navigation with NavX is feasible [KEY WORDS] Catheter Ablation ；Paroxysmal Supraventricular Tachycardia ； Tri-dimensional electronic navigation system ； X-ray fluoroscopy [1] RFCA 由于其安