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目的初步总结应用CARTO系统指导射频消融儿童快速右房房性心律失常的经验。方法右房房速(AT)3例,典型房扑(AF)1例,心动周期(277±31)ms,在心动过速时应用CARTO系统标测右房,重建三维电解剖图并指导射频消融靶点；房扑消融后分别在低位右房和冠状窦以500ms起搏作电解剖图,判断完全双向传导阻滞。结果2例为局灶性房速,起源点分别在希氏束旁(Koch三角)和高位右旁；1例为右房壁疤痕介导的折返性房性心动过速(IARF)。4例成功消融,放电次数(10．6 ± 5．5)次,透视时间(18±9)min,术程(110±38)min。结论(1)CARTO系统容易寻找最佳靶点；(2)房扑消融后在低位右房和冠状窦起搏作电解剖图,判断完全双向传导阻滞,大幅度减小X线透视时间,提高成功率,降低复发率。
Objective To summarize the experience of using CARTO system to guide the rapid ablation of right atrial atrial arrhythmias in children undergoing radiofrequency ablation. Methods Three cases of right atrial tachycardia (AT), 1 case of typical atrial flutter (AF), and cardiac cycle (277 ± 31) ms were used to mark the right atrium with CARTO system during tachycardia. The three-dimensional electro- Ablation target; ablation after atrial flutter in the lower right atrium and coronary sinus to 500ms pacing for electrical anatomy, to determine the complete bidirectional conduction block. Results Two cases were focal atrial tachycardia. The origins were located beside the Koch triangle (triangle) and the right upper side respectively. One case was scar-mediated reentrant atrial tachycardia (IARF). Four patients successfully ablated, the number of discharges was (10.6 ± 5.5) times, the time of fluoroscopy was (18 ± 9) min and the duration of operation was (110 ± 38) min. Conclusions (1) CARTO system is easy to find the best target; (2) After atrial flutter ablation in the low right atrial and coronary sinus pacing for electroanatomic map to determine the complete bidirectional conduction block, significantly reduce the X-ray fluoroscopy time, Improve the success rate, reduce the recurrence rate.