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目的运用64排螺旋CT图像与CARTO三维电解剖标测整合技术(Carto-Merge)指导阵发性房颤的导管消融治疗。方法22例经抗心律失常药物治疗效果欠佳的患者进行手术,患者术前1～3d行64排CT心脏成像检查,并将CT导入有Carto-Merge的软件包进行三维重建,重建后在Carto-Merge指导手术。结果所有患者均顺利完成手术,Carto-Merge整合误差为(1.8±0.62)mm,使用Carto-Merge患者平均手术时间为(98±28)min,X线曝光时间为(26±11)min。随访1～6个月,20例均无PAf发作,2例发作次数明显减少,所有患者术中术后均无严重并发症。结论Carto-Merge技术可有效地指导阵发性房颤的射频消融,简化操作,提高消融手术的成功率。
Objective To evaluate the catheter ablation of paroxysmal atrial fibrillation by using 64-slice spiral CT image and CARTO three-dimensional electroanatomic mapping and integration technology (Carto-Merge). Methods Twenty-two patients with poor response to antiarrhythmic drugs underwent surgery. The patients underwent 1-to-3 days preoperative 64-slice CT cardiac imaging. CT was imported into the Carto-Merge software package for three-dimensional reconstruction. After reconstruction, -Merge guidance surgery. Results All patients underwent surgery successfully. The error of Carto-Merge integration was (1.8 ± 0.62) mm. The average operation time was (98 ± 28) min with Carto-Merge and the time of X-ray exposure was (26 ± 11) min. All cases were followed up for 1 ~ 6 months. None of the 20 patients had any PAF attack. The number of attacks in 2 patients was significantly reduced. All the patients had no postoperative complications. Conclusion Carto-Merge technique can effectively guide the radiofrequency ablation of paroxysmal atrial fibrillation, simplify the operation and improve the success rate of ablation.