心脏心律失常射频消融治疗及其临床意义.pdfVIP

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Cardiacarrhythmiasarecommon,affecting3-5%oftheover40s,whichisexpectedtogrow

duetoageingpopulation[1].Cardiacarrhythmiascauseconsiderablemorbidityandsignificant

mortalityaswellasconsiderableanxietyinpatientsandtheirrelatives.Earlyandaccuratediagnosis

isessentialfortheselectionoftheappropriatetreatment.Overthelastdecadestheapplication

ofablationtherapyhasshownasasuccessfulalternativeoverdrugtreatment[2-5].Forthis,the

arrhythmogenicsubstrateiselucidatedbymeasuringtheelectrophysiological(EP)signalinsidethe

heart.Itisoftenpossibletocompletelycuretheconditionbyeitherburningtheendocardialsurface

wheretheabnormalelectricalactivityisoriginatingortoblockthepropaionoftheabnormal

electricalactivity.Thisprocedure,whichiscalledradio-frequency(RF)ablation,depositsRF

energyviaspeciallyadaptedcatheters.Currently,X-rayfluoroscopyisthestandardtechniqueused

forimageguidance.However,thisimagingmodalityoffersno3Dinformationandsofttissue

contrast,makingcatheternaviionwithintheheartdifficult.Inaddition,duetothe

electrophysiologicalcomplexityofthearrhythmiaanditsanatomicalsubstratetheprocedure

normallytakesseveralhourswithX-rayfluoroscopyandrequiresskilledoperators.Recently,

electro-anatomicalmappingsystems(BiosenseWebsterCarto,California,USA,andStJude

MedicalESI,MinnesotaUSA