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目的探讨和比较新型三维电解剖标测系统(CARTO3)及CT影像融合技术(CARTO-Merge)指导阵发性心房颤动与持续性心房颤动环肺静脉电隔离术(CPVI)的有效性和安全性。方法 52例经药物治疗无效且有房颤症状患者分为阵发性房颤组24例(A组)与持续性房颤组28例(B组)。将术前16排心脏CT扫描数据与CARTO3系统快速解剖标测重建三维解剖图形进行CARTO-Merge融合,指导CPVI,终点为消除所有肺静脉电位,未转律者行直流电复律。结果所有患者用环状标测导管Lasso建模,A组与B组间肺静脉前庭平均直径、平均手术总时间及平均冷盐水输入量差异均有统计学意义(均<0.05);两组CARTO三维消融靶点图与CT三维解剖图的平均距离、平均融合时间、平均X线曝光及消融时间差异均无统计学意义(均>0.05)。A组18例(75%)与B组14例(50%)患者消融转为窦律,两组均未发生严重并发症。结论 CARTO3及CARTO-Merge指导房颤CPVI具有较好的有效性与安全性。
Objective To investigate and compare the effectiveness and safety of the novel three dimensional electroanatomic mapping system (CARTO3) and the CARTO-Merge (CT) technique in guiding the paroxysmal atrial fibrillation and continuous atrial fibrillation pulmonary vein isolation (CPVI). Methods Fifty-two patients with AF and AF symptoms were divided into 24 patients (group A) with paroxysmal atrial fibrillation and 28 patients (group B) with persistent AF. CARTO-Merge fusion was performed with 16 anatomical cardiac CT scan data and CARTO3 system rapid anatomical mapping to reconstruct CARTO-Merge images. CPVI was performed at the end point to eliminate all pulmonary venous potentials. Results All patients were modeled by the ring mapping catheter Lasso. There was significant difference in average diameter of vestibular veins, total mean operative time, and average cold saline infusion between group A and group B (all <0.05) There was no significant difference in average distance, average fusion time, average X-ray exposure and ablation time between ablation target and CT three-dimensional anatomy (all> 0.05). A group of 18 patients (75%) and B group of 14 patients (50%) ablation into sinus rhythm, no serious complications in both groups. Conclusion CARTO3 and CARTO-Merge have good efficacy and safety in guiding CPVI of atrial fibrillation.