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目的观察CARTO三维标测系统引导下治疗房室结双径路并房室结折返性心动过速的效果。方法选取房室结双径路并房室结折返性心动过速患者40例,分为三维组和X线组两组,每组20例。三维组使用三维标测系统引导下消融,X线组使用X线引导下消融。比较两组手术持续时间、放电时间、即刻手术成功率、X线曝光时间、X线曝光量的差别。结果 CARTO三维标测系统可使手术持续时间明显缩短[(81.5±19.6)min比(100.8±28.2)min],差异有统计学意义(P<0.05),放电时间明显缩短[(148.2±43.2)s比(215.4±74.9)s],差异有统计学意义(P<0.05),X线曝光时间缩短[(4.5±1.5)min比(14.7±4.6)min],差异有统计学意义(P<0.05),X线曝光量减少[(8.9±2.9)m Gy比(27.6±9.0)m Gy],差异有统计学意义(P<0.05)。两组即刻手术成功率比较差异未见统计学意义(100%比95%,P>0.05)。结论在CARTO三维标测系统引导下治疗房室结双径路并房室结折返性心动过速安全、可行,且能提高手术效率,减少X线曝光量。
Objective To observe the effect of CARTO three-dimensional mapping system in the treatment of atrioventricular nodal dual path and atrioventricular nodal reentrant tachycardia. Methods Forty patients with atrioventricular nodal reentrant tachycardia and atrioventricular nodal pathways were selected and divided into three groups and X group, 20 cases in each group. Three-dimensional group using three-dimensional mapping system to guide the next ablation, X-ray group using X-ray ablation. The difference of operation duration, discharge time, immediate operation success rate, X-ray exposure time and X-ray exposure were compared between the two groups. Results The CARTO 3D mapping system significantly shortened the duration of operation (81.5 ± 19.6 min vs 100.8 ± 28.2 min) (P <0.05), and significantly reduced the discharge time (148.2 ± 43.2) s (215.4 ± 74.9) s], the difference was statistically significant (P <0.05) and the X-ray exposure time was shortened (4.5 ± 1.5 min vs (14.7 ± 4.6) min], the difference was statistically significant (P < 0.05). The X-ray exposure decreased (8.9 ± 2.9) m Gy (27.6 ± 9.0) m Gy, the difference was statistically significant (P <0.05). There was no significant difference between the two groups in the success rate of immediate surgery (100% vs 95%, P> 0.05). Conclusions It is safe and feasible to treat atrioventricular nodal dual pathway and atrioventricular nodal reentrant tachycardia under the guidance of CARTO three dimensional mapping system and can improve the operation efficiency and reduce the X-ray exposure.