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目的评价在低频率X线曝光下应用EnSite NavX三维标测系统引导射频消融房室结折返性心动过速(AVNRT)的安全性、有效性。方法选择2011年4月至2015年2月在本院住院的阵发性室上性心动过速患者,经食管调搏筛选出103例AVNRT。将入选患者分为研究组61例和常规组42例。研究组低频率X线曝光下应用NavX指导消融,常规组X线透视消融。观察两组的手术成功率、手术操作时间、放电次数、放电时间、X线曝光时间和并发症。结果研究组中2例经术中心内电生理检查诊断分别更正为房性心动过速和间隔旁道致房室折返性心动过速而剔除出组,其余研究组及常规组均成功完成手术。与常规组比较,研究组手术时间减少[(46.5±11.7)min vs(63.4±14.5)min,P<0.01],X线曝光时间明显缩短[(192±103)s vs(413±112)s,P<0.01],放电次数显著减少[(3±1)次vs(7±2)次,P<0.01],放电时间显著缩短[(184±69)s vs(378±77)s,P<0.01]。术中常规组发生1例房室传导阻滞。结论低频率X线曝光下在EnSite NavX三维标测系统引导射频消融治疗AVNRT安全,在缩短X线曝光时间的同时提高了手术效率。
Objective To evaluate the safety and efficacy of EnSite NavX 3D mapping system for radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT) under low-frequency X-ray exposure. Methods From April 2011 to February 2015, 103 patients with paroxysmal supraventricular tachycardia admitted to our hospital underwent esophageal pacing to screen out 103 cases of AVNRT. The selected patients were divided into study group 61 cases and routine group 42 cases. The study group under the low-frequency X-ray exposure using NavX guidance ablation, conventional group X-ray fluoroscopy. The success rate of surgery, operation time, discharge times, discharge time, X-ray exposure time and complications were observed. Results In the study group, 2 cases were diagnosed by electrophysiological examination in the center of the surgery and corrected for atrial tachycardia and atrioventricular reentrant tachycardia were excluded from the study. The rest of the study group and the conventional group were successfully completed. Compared with the conventional group, the operation time of the study group decreased (46.5 ± 11.7 min vs 63.4 ± 14.5 min, P <0.01), and the X-ray exposure time was significantly shorter (192 ± 103 s vs 413 ± 112 s , P <0.01]. The number of discharges was significantly reduced [(3 ± 1) vs (7 ± 2) times, P <0.01] and the discharge time was significantly shorter [(184 ± 69) s vs (378 ± 77) <0.01]. Intraoperative routine group occurred in 1 case of atrioventricular block. Conclusions The low-frequency X-ray exposure guides the radiofrequency ablation of AVNRT in the EnSite NavX 3D mapping system, which can shorten the X-ray exposure time and improve the operation efficiency.