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目的:观察Carto系统指导下环肺静脉线性消融治疗心房颤动的临床疗效。方法:28例心房颤动(阵发性23例,持续性5例)患者行射频消融治疗。Carto系统指导下构建左心房电解剖图,行双侧环肺静脉线性消融,环状标测电极验证肺静脉达到电隔离效果。若术中心房颤动不终止,则继续消融左房顶部线、二尖瓣峡部线或三尖瓣峡部线,如心房颤动仍未终止,遂行同步直流电复律恢复至窦性心律。结果:28例患者均成功完成手术,其中18例只需完成双侧环肺静脉线性消融,10例需要继续行左房顶部线、二尖瓣峡部线或三尖瓣峡部线的消融。随访3～29个月,2例复发房颤,2例复发房性心动过速,所有患者的手术成功率为86%。结论:Carto系统指导下环肺静脉线性消融治疗心房颤动短至中期随访效果确切,具有较高成功率。
Objective: To observe the clinical effect of circumferential ablation of pulmonary vein guided by Carto system in the treatment of atrial fibrillation. Methods: 28 patients with atrial fibrillation (paroxysmal 23 cases, 5 cases of persistent) patients underwent radiofrequency ablation. Carto system under the guidance of the construction of left atrial electrical anatomy, line bilateral circumferential pulmonary vein ablation, annular calibration electrode to verify the pulmonary vein electrical isolation effect. If the operation of atrial fibrillation does not terminate, continue to ablation of the left atrial top line, mitral valve isthmus line or the tricuspid isthmus line, such as atrial fibrillation has not yet terminated, then perform synchronous DC cardioversion to sinus rhythm. RESULTS: Twenty-eight patients underwent successful surgery. Of the 18 patients, only bilateral circumferential pulmonary vein ablation had to be completed, and the ablation of the left atrium top line, mitral isthmus, or tricuspid isthmus was required in 10 of 18 patients. The patients were followed up for 3 to 29 months. Two patients had recurrent atrial fibrillation and two patients had recurrent atrial tachycardia. The successful rate of operation in all patients was 86%. CONCLUSION: Carto system guided circumferential pulmonary vein ablation for a short to mid-term follow-up of atrial fibrillation has an exact and high success rate.