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目的探讨磁导航技术应用于室上性心律失常消融治疗的有效性和安全性。方法对不同类型室上性心律失常患者,在常规电生理标测的基础上,采用NiobeⅡ磁导航系统(Stereotaxis,Inc)遥控操作进行温控射频消融治疗。5例入院诊断室上性心律失常患者,男3例,女2例,平均年龄(45±18)岁。2例有器质性心脏病病史。心内电生理诊断心房扑动2例,其中1例合并房室结折返性心动过速,右后间隔显性房室旁道1例,左后游离壁隐匿性旁道1例。结果5例利用常规心内电生理标测后均采用磁导航系统遥控操作精确标测靶点并行射频消融,4例成功。操作时间(116±31)min,术者X光曝光时间仅为(4.5±1.5)min。5例患者均未发生手术并发症。结论对不同类型室上性心律失常,初步研究表明,采用磁导航技术均可安全与有效地实施遥控标测和消融治疗,并且明显降低术者的X光曝光时间。
Objective To investigate the effectiveness and safety of magnetic navigation in ablation of supraventricular arrhythmia. Methods Different types of patients with supraventricular arrhythmias were treated with remote controlled radiofrequency ablation (RFA) using Niobe Ⅱ Magnetic Navigation System (Stereotaxis, Inc) on the basis of conventional electrophysiological mapping. Five patients were admitted to the diagnosis of supraventricular arrhythmias, 3 males and 2 females, mean age (45 ± 18) years old. 2 cases had a history of organic heart disease. Atrial electrophysiological diagnosis of atrial flutter in 2 cases, including 1 case of atrioventricular nodal reentrant tachycardia, right posterior compartment of the dominant aortic pathway in 1 case, the left posterior free wall in 1 case of occult bypass. Results Five cases of conventional intracardiac electrophysiological mapping were performed using magnetic navigation system remote control to accurately locate the target and perform radiofrequency ablation. Four cases were successful. The operation time (116 ± 31) min, the surgeon X-ray exposure time was only (4.5 ± 1.5) min. None of the 5 patients had any surgical complications. Conclusion Different types of supraventricular arrhythmias, preliminary studies have shown that the use of magnetic navigation technology can be safely and effectively remote mapping and ablation treatment, and significantly reduce the surgeon X-ray exposure time.