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目的环形标测电极指导下的环肺静脉电隔离是心房颤动(简称房颤)消融的基础术式。本多中心研究旨在评估单用磁导航导管法行房颤首次消融术的安全性和有效性。方法入选两家中心的房颤患者503例(阵发性房颤309例,持续性房颤194例),行环肺静脉电隔离消融术。观察手术并发症、手术时间、消融时间以及X线曝光时间等相关手术参数。术后随访3个月,观察房颤消融成功率。结果 493例(98%)房颤患者首次消融术中获得双侧肺静脉电隔离。术中及术后3个月内无心包压塞、左房食管瘘等严重手术相关并发症。手术时间、消融时间和X线曝光时间分别为(133±35)min、(35±16)min、(4.9±3.0)min。与阵发性房颤相比,持续性房颤手术时间和消融时间分别延长11%[(141±34)min vs(127±35)min,P<0.01]和29%[(41±16)min vs(32±16)min,P<0.001],X线曝光时间无显著差别(P=0.45)。术后3个月随访,阵发性房颤消融成功率明显高于持续性房颤(70%vs 51%,P<0.01)。结论应用单根磁导航消融导管行房颤首次消融术是安全和有效的,同时可明显降低X线曝光时间。
The purpose of the ring mapping electrode under the guidance of the pulmonary vein isolation is the basis of atrial fibrillation (AF) ablation based on surgery. This multicenter study was designed to evaluate the safety and efficacy of a first magnetic catheter ablation for AF with first ablation. METHODS: A total of 503 patients with AF (309 paroxysmal atrial fibrillation, 194 patients with persistent AF) were enrolled in the two centers. Circumferential pulmonary vein isolation and ablation was performed. Observe the surgical complications, operation time, ablation time and X-ray exposure time and other related surgical parameters. The patients were followed up for 3 months to observe the success rate of atrial fibrillation ablation. Results Bilateral pulmonary venous electrical isolation was obtained during the first ablation of 493 patients (98%) with AF. Intraoperative and postoperative 3 months no atrophic occlusion, left atrial esophageal fistula and other serious surgery-related complications. The operation time, ablation time and X-ray exposure time were (133 ± 35) min, (35 ± 16) min and (4.9 ± 3.0) min, respectively. Compared with patients with paroxysmal atrial fibrillation, the duration of operation and the ablation time of persistent atrial fibrillation were prolonged by 11% (141 ± 34) min vs 127 ± 35 min (P <0.01) and 29% (41 ± 16) min vs 32 ± 16 min, P <0.001]. There was no significant difference in X-ray exposure time (P = 0.45). After 3 months of follow-up, the success rate of paroxysmal atrial fibrillation ablation was significantly higher than that of persistent atrial fibrillation (70% vs 51%, P <0.01). Conclusions The first ablation of magnetic resonance catheter ablation catheter in atrial fibrillation is safe and effective, and the X-ray exposure time can be significantly reduced.