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目的探索采用新型多极冷盐水灌注标测与消融导管(n MARQ)进行肺静脉隔离(PVI)的安全性和有效性。方法心房颤动(简称房颤)患者接受10极n MARQ导管射频消融完成PVI。消融术后观察15 min,应用Lasso标测导管检验PVI,必要时再次应用n MARQ导管进行补点消融。记录每根肺静脉标测时间、消融时间、消融能量输出模式和PVI情况。结果共对9例33根静脉进行130次消融,其中左上肺静脉(LSPV)44次(33.8%)、左下肺静脉(LIPV)38次(29.2%)、右上肺静脉(RSPV)24次(18.5%)、右下肺静脉(RIPV)24次(18.5%),平均每根肺静脉消融3.9次。10极电极同时放电消融65次,选择性放电消融65次。Lasso电极检验PVI显示5根肺静脉(15.2%)发生电传导恢复,均为LIPV。平均每根肺静脉标测时间9.9 min、消融时间3.6 min。平均每例患者手术时间134 min,总标测时间37 min,总消融时间13 min,X线累计曝光时间21 min、X线累计曝光剂量35460 m Gy/cm2。消融过程中食管温度报警18次(13.8%),其中LSPV 4次(9.1%)、LIPV 10次(26.3%)、RIPV 4次(16.7%)。消融术后即刻PVI成功率93.9%。术中和术后住院期间无射频消融相关主要并发症发生。结论房颤患者应用新型标测与消融多极导管进行PVI手术安全、有效。
Objective To explore the safety and efficacy of pulmonary vein isolation (PVI) using the new multi-polar cold saline perfusion mapping and ablation catheter (n MARQ). Methods Atrial fibrillation (atrial fibrillation) patients underwent 10-pole n MARQ catheter radiofrequency ablation completed PVI. Observed after ablation 15 min, the application of Lasso catheter mapping PVI, if necessary, again n MARQ catheter for fill point ablation. Record each pulmonary vein mapping time, ablation time, ablation energy output mode and PVI situation. Results A total of 33 ablations were performed in 130 patients (33 cases), including left upper pulmonary vein (LSPV) 44 times (33.8%), left lower pulmonary vein (LIPV) 38 times (29.2%), right upper pulmonary vein (RSPV) 24 times The right lower pulmonary vein (RIPV) was 24 times (18.5%) with an average 3.9 ablations per pulmonary vein. Electrode discharge 10 electrodes simultaneously ablation 65 times, selective discharge ablation 65 times. Lasso Electrode Examination PVI showed electrical conduction recovery in 5 pulmonary veins (15.2%), all LIPV. Average pulmonary vein mapping time of 9.9 min, ablation time of 3.6 min. The average operation time of each patient was 134 min, the total measurement time was 37 min, the total ablation time was 13 min, the X-ray cumulative exposure time was 21 min and the X-ray exposure dose was 35460 m Gy / cm 2. The temperature of the esophagus was 18 times (13.8%) during the ablation, with LSPV 4 times (9.1%), LIPV 10 times (26.3%) and RIPV 4 times (16.7%). PVI success rate after ablation was 93.9%. No intraoperative and postoperative hospital-based radiofrequency ablation associated with major complications. Conclusion Atrial fibrillation patients with new mapping and ablation of multi-pole catheter for PVI surgery safe and effective.