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目的:报道2例心房颤动(房颤)持续过程中Lasso环状标测电极导管(Lasso电极)指导心脏大静脉 (大静脉)电隔离治疗。方法:2例患者临床症状和心电图记录提示分别为阵发性房颤(PAF)和持续性房颤。经股静脉和颈内静脉穿刺置入右心室和冠状静脉窦电极导管,并行房间隔穿刺和选择性大静脉造影。置入10极 Lasso电极进行大静脉标测。应用普通温控消融导管以局部异常电活动相对最早或频率最快、最紊乱处开始消融,在房颤持续过程中电隔离大静脉至左房连接处,以房颤终止和异常电活动消失或后者与心房电活动无关为消融终点。结果:2例患者共消融7条大静脉。1例PAF患者完成上腔静脉(SVC)和右上肺静脉(RSPV)电隔离后,消融左上肺静脉(LSPV)过程中房颤终止。另1例持续性房颤患者完成SVC、RSFV、LSPV及右下肺静脉电隔离,加做左房峡部、三尖瓣-下腔静脉峡部线性消融后,同步电复律使房颤转为窦性心律。随访1年,无房颤复发和相关并发症。结论:Lasso电极指导下应用普通温控消融导管可于心房颤动持续过程中电隔离大静脉而治疗房颤。
OBJECTIVE: To report the electrical isolation of the large cardiac vein (large vein) guided by Lasso ring-shaped lead (Lasso electrode) during the continuous course of 2 cases of atrial fibrillation (AF). Methods: The clinical symptoms and electrocardiographic recordings in 2 patients were paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation, respectively. The femoral vein and internal jugular vein puncture into the right ventricle and coronary sinus catheter, parallel atrial septal puncture and selective venography. The 10-pole Lasso electrodes were placed into the large vein. The application of common temperature ablation catheter to local anomalous electrical activity relative to the earliest or the fastest frequency of the most disruptive at the beginning of ablation in the process of atrial fibrillation electrical isolation of large venous connection to the left atrium to atrial fibrillation termination and abnormal electrical activity disappear or The latter has nothing to do with the atrial electrical activity as the end point of ablation. Results: Two patients were ablated seven large veins. Atrial fibrillation was terminated during ablation of the left upper pulmonary vein (LSPV) in 1 PAF patient after electrical isolation of the superior vena cava (SVC) and right superior pulmonary veins (RSPV). Another 1 patient with persistent AF completed SVC, RSFV, LSPV and the right lower pulmonary vein electrical isolation, plus left atrial isthmus, tricuspid - inferior vena cava isthmus linear ablation, synchronous electrical cardioversion atrial fibrillation to sinus Heart rate. One year follow-up, no recurrence of AF and related complications. Conclusion: Lasso electrodes under the guidance of the application of common temperature ablation catheter in the process of atrial fibrillation during the isolation of large intravenous atrial fibrillation and treatment.