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目的评价图像融合系统指导下构建的左心房三维结构对心房颤动射频导管消融效果的影响。方法回顾性分析连续接受消融的80例心房颤动患者,其中42例在图像融合系统指导下(A组)、38例单纯在常规电解剖标测系统指导下(B组)行消融。消融策略:左右侧肺静脉环形电隔离→左心房碎裂电位消融→左心房顶部、底部、峡部和右房三尖瓣峡部、上腔静脉、冠状窦口部消融。结果A组平均随访21.2±3.6月,36例(85%)3月后生活质量明显改善,无心房颤动复发,其中3例扩张型心肌病和1例肥厚型心肌病消融成功,术后心功能明显改善。B组平均随访22.1±3.3月,27例(71%)3月后生活质量明显改善,无心房颤动复发;另2例在再次消融后痊愈。结论图像融合系统能提高心房颤动消融的手术成功率。
Objective To evaluate the effect of three-dimensional structure of left atrium constructed under the guidance of image fusion system on radiofrequency catheter ablation of atrial fibrillation. Methods Eighty patients with atrial fibrillation who underwent continuous ablation were retrospectively analyzed. Among them, 42 patients were under the guidance of image fusion system (group A) and 38 patients underwent simple radiography (group B) under the guidance of conventional electroanatomic mapping system. Ablation strategy: left and right pulmonary vein annular electrical isolation → left atrial fissuration potential ablation → left atrial top, bottom, isthmus and right atrial tricuspid isthmus, superior vena cava, coronary sinus ablation. Results The average quality of life in group A was significantly improved after 36 months (85%) and no recurrence of atrial fibrillation was observed in group A at 21.2 ± 3.6 months. Three cases of dilated cardiomyopathy and one case of hypertrophic cardiomyopathy were successfully ablated. The postoperative cardiac function Significant improvement. In group B, the average follow-up was 22.1 ± 3.3 months, 27 cases (71%) had a significant improvement in quality of life after 3 months without recurrence of atrial fibrillation and the other 2 cases recovered after reabsorption. Conclusion Image fusion system can improve the success rate of atrial fibrillation ablation.