EnSite+Velocity+系统指导单导管射频导管消融右心室流出道室性期前收缩的初步体会.pdfVIP

心电与循环2014 年第33 卷第3 期 论 著 EnSite Velocity 系统指导单导管 射频导管消融右心室流出道室性 期前收缩的初步体会 黄鸿博 沈才杰 陈晓敏 孙立勤 储慧民 [摘要] 目的 探讨EnSite Velocity 系统指导单导管射频消融（RFCA ）治疗右心室流出道（ROVT ）室性期前收缩（PVCs ）的 可行性。 方法 28 例药物未能控制的ROVT PVCs 患者行单导管消融术，消融导管在EnSite Velocity 系统指导下进行解剖 标测重建RVOT 模型，经激动顺序标测及起搏标测明确消融靶点。 结果 RVOT 建模时间及所需X 线曝光时间为（6.6 ±2.2 ） min、（0.5 ±0.4 ）min。即刻消融成功率100%，异位起搏点起源自间隔部17 例（60.7% ）、前壁3 例、后壁3 例、游离壁5 例。消融靶 点较体表QRS 波群起点提前（34.2 ±5.1 ）ms。手术总时间、总X 线曝光时间、标测时间、消融时间分别为（56.2 ±13.9 ）min、 （1.1 ±0.7 ）min、（15.5 ±8.2 ）min、（5.5 ±2.9 ）min ，其中6 例零X 线曝光。术中、术后没有相关并发症出现，观 （19.7 ±8.6 ）d ，复 发 1 例。 结论 RVOT PVCs 多起源于间隔部，经EnSite Velocity 系统指导的单导管消融安全有效。 [关键词] EnSite Velocity 系统； 右心室流出道； 室性期前收缩； 射频导管消融 The initial experiences in radiofrequency catheter ablation of right ventricular outflow tract premature ventricular contracts with a single catheter guided by EnSite Velocity system H UA NG Hongbo, SHEN Caij ie, CHEN X iaomin, et al. Department of Cardiology, Ningbo First Hosp ital,Ningbo315010, China Corresp onding author:CH U H uimin, E-mail:shenz ihai1101@126.com [Abstract] Objective To explore the feasibility of radiofrequency catheter ablation (RFCA) of right ventricular outflow tract (RVOT) premature ventricular contract (PVC) with a single catheter guided by EnSite Velocity system. Methods 28 patients with symptomatic RVOT PVCs refractory to medicines underwent single-catheter ablation. RVOT electroanatomical map was reconstructed by catheter mapping guided by EnSite Velocity system. PVC loci were localized by activation sequence mapping and pacing mapping. Results The times for electroanatomical reconstruction of RVOT and X-ray exposure were 6.6 ±2.2 min and 0.5 ±0.4 min, respectively. RFCA was successful in all cases. PVC originated from septum (17 cases), anterior wall (3 cases), posterior wall(3 cases) and free wall(5 cases).The site of abla