摘要
目的对主动脉窦起源的室性心律失常进行标测和消融需要准确和安全。本研究尝试采用EnSiteNavX标测技术对起源于主动脉窦的室性心动过速（室速）和／或室性早搏（室早）进行消融。方法运用NavX标测系统构建主动脉窦、升主动脉及冠状动脉开口的三维电解剖及激动顺序图，同时进行冠状动脉造影，以确认NavX导航的准确性。结合传统的电生理标测，射频消融治疗24例主动脉窦起源的室早和／或室速。结果24例均射频消融成功，其中，左冠窦内起源16例，右冠窦内起源4例，左、右冠窦问起源4例，术中和术后无并发症。消融时间及x线曝光时间（包括冠状动脉造影时间）分别为（56．1±18．3）min、（11．2±6．8）min。1例患者消融前发现合并左旋支中段狭窄，消融术后成功行支架术。平均随访（16_＋12）个月，1例室速患者有室早复发，再次消融成功。结论NavX标测技术可以代替冠状动脉造影，指导主动脉窦起源的室早和／或室速的标测和消融。
Objective To study the feasibility and safety of radiofrequency catheter ablation （RFCA） of ventrieular tachycardia （VT） or ventricular premature contraction （ VPC ） originating from the aortic cusp under the guidance of EnSite NavX system. Methods Twenty-four patients with VT/VPC originating from aortic cusp were enrolled. The geometry of aortic cusp was reconstructed using NavX mapping technique and the accuracy was confirmed by coronary angiography. Ablation was applied at the site with earliest activation. Results The VTs/PVCs in all 24 cases were successfully ablated, and the targets were located on left coronary cusp in 16, right coronary cusp in 4,anterior wall of aortic between left and right coronary cusp in 4. There was no proce- dure-related complication occurred. The total procedure time was （56. 1 _＋ 18.3 ）min, and the fluoroscopic time （coronary angiography time included）was（ 11.2-＋6. 8 ）min. Left circumflex artery stenosis was documented be- fore mapping in 1 case and stenting procedure was performed after RFCA. There was only one VT case with PVC recurrence during a （16＋ 12 ）months follow-up, and re-ablation succeeded. Conclusion NavX mapping and navigation technique is feasible and safe to guide the ablation of VT/VPC with aortic cusp origin.
出处
《中华心律失常学杂志》
2011年第6期418-420,共3页
Chinese Journal of Cardiac Arrhythmias
关键词
室性心动过速
室性早搏
主动脉窦
导管消融
NavX标测
Ventficular tachycardia
Ventricular premature contraction
Aortic sinus cusp
Catheter ab-lation
NavX mapping
作者简介
通信作者：姚焰，Email：ianyao@263．net．cn
