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目的评价磁导航系统对房室结折返性心动过速导管射频消融的指导作用。方法将经过心内电生理检查确诊的房室结折返性心动过速患者随机分为两组,A组采用常规技术和4mm温控导管消融,B组采用磁导航系统和温控磁大头导管消融。两组各入选10例患者,其年龄、性别、心动过速病史和基础心血管疾病具有可比性。比较两组患者如下参数:消融操作时间、患者透视时间、术者透视时间、放电次数、消融能量、成功率、并发症、手术费用。结果两组患者全部一次消融成功,无并发症,术后住院时间相同,随访(7.1±1.4)个月,无心动过速复发。磁导航消融组的操作时间、患者和术者透视时间、放电次数和实际消融能量均明显低于常规消融组,但手术费用高于常规消融组。结论采用磁导航系统指导房室结慢径路导管射频消融能明显缩短消融操作时间及患者和术者的透视时间,减少放电次数,降低实际消融能量。
Objective To evaluate the guidance of magnetic navigation system in radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia. Methods Atrioventricular nodal reentrant tachycardia confirmed by electrophysiological examination were randomly divided into two groups. Group A was treated with conventional technique and 4 mm temperature-controlled catheter ablation. Group B was treated with magnetic navigation system and temperature-controlled magnetic head ablation . Ten patients were enrolled in both groups and were comparable in age, sex, history of tachycardia, and underlying cardiovascular disease. The following parameters were compared between the two groups: ablation time, patient fluoroscopy time, fluoroscopy time, number of discharges, ablation energy, success rate, complications, and surgery costs. Results All the patients in one group had successful ablation at one time without complication, and had the same postoperative hospital stay. No recurrence of tachycardia was observed after (7.1 ± 1.4) months of follow-up. Magnetic navigation ablation group operation time, patients and surgeons fluoroscopy time, the number of discharges and the actual ablation energy were significantly lower than the conventional ablation group, but the cost of surgery was higher than the conventional ablation group. Conclusion Magnetic navigation system to guide the radiofrequency catheter ablation of atrioventricular node can significantly shorten the operation time of ablation and the fluoroscopy time of patients and surgeons, reduce the number of discharge and reduce the actual ablation energy.