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目的评价多极接触标测在指导三维电解剖引导下右室流出道(RVOT)室性早搏(简称室早)消融的疗效。方法选择32例RVOT室早患者,据术中室早发作的频度分为两组:室早<1次/分者采用多极导管高密度标测(多极组);室早≥1次/分者采用单导管逐点标测(单极组);确定激动起源靶点后再进行起搏标测证实并实施消融治疗。比较两组的标测时间、消融次数及时间、X线曝光时间、消融成功率。结果 29例患者完成电生理标测及消融,单极组16例,多极组13例。多极组平均采集有效标测点明显多于单极组;激动顺序标测耗时两组未见差异。多极组总手术时间明显长于单极组,但是在平均消融次数、消融时间、X线透视时间等指标比较,多极组却显著少于单极组,所有患者均达到即刻消融终点。随访(6.9±3.2)个月,单极组1例复发。结论采用多极标测导管对RVOT局部进行高密度电解剖标测快捷、精确,提高消融成功率,尤其是对术中室早发作较少的患者。
Objective To evaluate the efficacy of multipolar contact mapping in guiding the ablation of ventricular premature beats in right ventricular outflow tract (RVOT) guided by three-dimensional electroanatomy. Methods 32 patients with early RVOT were selected and divided into two groups according to the frequency of preoperative seizure: as early as <1 times / minute, multi-polar catheter high density (multipolar) / Points using single-catheter point-by-point mapping (unipolar group); determine the source of excitement before pacing mapping and implementation of ablation therapy. Compare the mapping time, ablation frequency and time, X-ray exposure time, ablation success rate. Results 29 patients completed electrophysiological mapping and ablation, monopolar group of 16 cases, multipolar group of 13 cases. Multipole group average collection of effective calibration points significantly more than monopolar group; Excitation sequence mapping time consuming two groups no difference. The total operation time of multipolar group was significantly longer than that of unipolar group. However, the average number of ablation, ablation time, X - ray time and other indicators were significantly less in the multipolar group than in the unipolar group, and all the patients reached the immediate end of ablation. Follow-up (6.9 ± 3.2) months, monopolar group 1 case of recurrence. Conclusions Multipolar catheter can be used to rapidly and accurately measure RVOT locally and improve the success rate of ablation, especially for patients with less premature seizures in the operation room.