目的观察Carto系统引导下心房颤动(房颤,AF)射频消融术(RFCA)前后患者心肌生化标记物心肌肌钙蛋白(IcTNI)、肌红蛋白(MYO)、肌酸磷酸激酶同工酶(CK-MB)的变化;了解RFCA术后心肌损伤程度与消融因素的关系。方法选择在Carto系统引导下行房颤RFCA术患者20例,分为两组,一组未消融碎裂电位,仅行肺静脉前庭环形标测消融,另一组增加碎裂电位消融,于术前及术后4～5h检测cTNI、MYO、CK-MB并进行比较。结果20例患者RFCA术后均未出现并发症,未消融碎裂电位组cTNI术前基础值为0.05±0.03ng/ml,术后4～5h为0.38±0.27ng/ml,较术前明显升高,结果有显著性差异(p=0.002);CK-MB术前基础值0.86±0.37ng/ml,术后4～5h为1.6±0.88ng/ml,较术前升高,有统计学差异(p=0.016);MYO术前基础值为41.8±17.5ng/ml,术后4～5h为121.8±65.8ng/ml,较术前升高,有统计学差异(p=0.001);消融碎裂电位组cTNI术前基础值为0.07±0.05ng/ml,术后4～5h为1.83±1.66ng/ml,较术前明显升高,结果有显著性差异p=0.03;CK-MB术前基础值1.23±0.34ng/ml,术后4～5h为3.4±2.8ng/ml,较术前升高,无统计学差异(p=0.096);MYO术前基础值为57.4±22.9ng/ml,术后4～5h为130.1±53.4ng/ml,较术前升高,有统计学差异(p=0.03);而消融碎裂电位组术后与未消融碎裂电位组相比cTNI、CK-M患者MYO无统计学差异p分别为0.06,0.14,0.781。结论cTNI、MYO在消融碎裂电位组及未消融碎裂电位组RFCA术前后变化均有显著性差异;CK-MB在未消融碎裂电位组升高,术后较术前有显著升高,而在消融碎裂电位组术前术后无统计学差异;两组术后心肌酶学无统计学差异,说明消融碎裂电位不会对心肌组织产生更严重的损伤。 Objective To observe the changes of cardiac biomarkers such as cardiac troponin IcTNI, myoglobin (MYO) and creatine phosphokinase isoenzyme (CK) before and after radiofrequency catheter ablation (AFCA) guided by Carto system -MB) changes; to understand the relationship between RFCA myocardial injury and ablation factors. Methods Twenty patients undergoing RFCA with atrial fibrillation guided by Carto system were divided into two groups. One group had no ablation fragmentation potential. Only the vestibular ring of pulmonary veins was measured and ablated, while the other group was treated with ablation of fragmentation potential. After 4 ~ 5h cTNI, MYO, CK-MB were detected and compared. Results No complications were found in 20 patients after RFCA. The preoperative baseline value of cTNI was 0.05 ± 0.03ng / ml in non-ablated group and 0.38 ± 0.27ng / ml in 4 ~ 5h after operation, which was significantly higher than that before operation (P = 0.002). The basal value of CK-MB preoperatively was 0.86 ± 0.37ng / ml and 1.6 ± 0.88ng / ml 4 ~ 5h after operation, which was significantly higher than that before operation (p = 0.016). The preoperative baseline value of MYO was 41.8 ± 17.5ng / ml and 121.8 ± 65.8ng / ml at 4 ~ 5h after operation, which was significantly higher than that before operation (p = 0.001) The preoperative baseline value of cTNI was 0.07 ± 0.05 ng / ml in preoperative group and 1.83 ± 1.66 ng / ml in postoperative 4 ~ 5 hours, which was significantly higher than that before operation (p = 0.03). Before CK-MB preoperative The basal value was 1.23 ± 0.34ng / ml and 3.4 ± 2.8ng / ml at 4 ~ 5h postoperatively, which was significantly higher than that before operation (p = 0.096). The baseline preoperative value of MYO was 57.4 ± 22.9ng / ml (P = 0.03). Compared with non-ablation fragmentation potential group, the levels of cTNI, CK -M patients with no significant difference MYO p were 0.06,0.14,0.781. Conclusions The changes of cTNI and MYO before and after RFCA in ablation fragmentation potential group and non-ablation fragmentation potential group were significantly different. CK-MB increased in non-ablation fragmentation potential group and was significantly higher than that before operation , While there was no significant difference in preoperative and postoperative ablation fragmentation potential group. There was no significant difference between the two groups in postoperative myocardial enzymology, indicating that ablation fragmentation potential would not cause more serious damage to myocardial tissue.