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目的研究慢性房颤导管消融治疗中运用倒“U”形态导管标测消融二尖瓣峡部的有效性。方法塑形成倒“U”形态的CARTO盐水标测消融导管紧密贴靠于二尖瓣峡部,窦性心律下起搏冠状静脉窦远端,若CARTO导管心房波近端早于远端,则提示逆钟向阻滞,同理起搏CARTO导管远端,验证顺钟向阻滞。结果 40例慢性房颤患者,运用倒“U”形态导管标测消融二尖瓣峡部,31例患者实现二尖瓣峡部的双向阻滞,与CARTO激动标测结果一致,其余9例患者未实现二尖瓣峡部的双向阻滞。术后随访(12.7±5.2)个月,在实现二尖瓣峡部双向阻滞的患者中7例(22.6%)复发,未实现二尖瓣峡部双向阻滞的患者中4例(44.4%)复发。结论运用倒“U”形态导管标测消融二尖瓣峡部是一种简单、快速、有效的导管操作方法 。
Objective To investigate the effectiveness of mitral isthmus in the ablation of chronic atrial fibrillation (AF) catheter using inverted U-shaped catheter. Methods The CARTO saline mapping ablation catheter with the inverted “U” shape was put in close contact with the isthmus of the mitral valve and the sinus venous distal pacing was performed under the sinus rhythm. If the proximal end of the CARTO catheter was earlier than the distal end, Then prompt inverse clock block, empathy pacing CARTO distal catheter, the verification clockwise block. Results In 40 patients with chronic atrial fibrillation, the mitral isthmus was labeled with inverted U-shaped catheter and 31 patients with bilateral isthmus of the mitral valve. The results were consistent with those of the CARTO excitement mapping. The remaining 9 patients Did not achieve two-way block mitral isthmus. Seven patients (22.6%) in the two-way block of mitral isthmus relapsed after surgery (12.7 ± 5.2) months, and 4 (44.4%) patients did not achieve mitral valve isthmus . Conclusions It is a simple, rapid and effective method to catheterize mitral isthmus using the inverted U-shaped catheter.