首都医科大学学报 ›› 2016, Vol. 37 ›› Issue (1): 54-57.doi: 10.3969/j.issn.1006-7795.2016.01.011

• 心脑血管疾病临床与基础研究 • 上一篇    下一篇

可调弯鞘在心房颤动环肺静脉隔离术中的应用经验

林涛, 魏欣, 徐晓薇, 马岩, 王蕊, 田俊萍, 郭晓彬, 陈步星   

  1. 首都医科大学附属北京天坛医院心内科, 北京 100050
  • 收稿日期:2015-12-10 出版日期:2016-02-21 发布日期:2016-02-01
  • 通讯作者: 陈步星 E-mail:chbux@126.com
  • 基金资助:
    首都特色临床应用研究(Z131107002213106)。

Experience in using a steerable sheath during the pulmonary veins isolation for paroxysmal atrial fibrillation ablation

Lin Tao, Wei Xin, Xu Xiaowei, Ma Yan, Wang Rui, Tian Junping, Guo Xiaobin, Chen Buxing   

  1. Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
  • Received:2015-12-10 Online:2016-02-21 Published:2016-02-01
  • Supported by:
    This study was supported by Capital Special Study of Clinical Application (Z131107002213106).

摘要: 目的 使用可调弯鞘(Agilis NxT 鞘)对阵发性心房颤动(以下简称房颤)进行导管消融隔离双侧肺静脉。方法 26例阵发性房颤患者,应用可调弯鞘支持下进双侧肺静脉行隔离术。穿刺房间隔,双侧肺静脉造影后,在EnSite VelocityTM v3.0指导下构建左心房几何模型,行双侧肺静脉电学隔离。结果 26例患者均完成环肺静脉电学隔离。平均手术时间为(165.7±48.1)min,平均放射时间为(25.0±9.4)min,其中房间隔穿刺透视时间为(1.3±0.5)s,应用环状电极建模时间(7.5±4.3)min,左肺静脉隔离时间(55±17)min,右肺静脉隔离时间(37±11)min。有1例患者发生心脏压塞,经心包穿刺后好转。随访6~12个月,有3例患者(11.5%)复发。结论 Agilis NxT可以应用于针对阵发性房颤导管消融的环肺静脉隔离,可以减少导管在心腔内的操作,简化手术过程,具有较好的安全性和有效性。

关键词: 心房颤动, 射频消融, 可调弯鞘管

Abstract: Objective To report the experience of using a steerable sheath (Agilis NxT sheath) during the pulmonary veins isolation for paroxysmal atrial fibrillation (AF) ablation.Methods Twenty-six patients with paroxysmal AF (PaAF,n=26) underwent mapping and ablation using Agilis NxT sheath.The procedures of left atrium geometry was created undergoing mapping by EnSite VelocityTM v 3.0 after puncture of atrium septum and pulmonary veins angiography. Circumferential pulmonary veins isolation (CPVI) was performed using Agilis NxT sheath.Results Four PVIs were successfully performed in all 26 patients. The average operation time was (165.7±48.1) minutes, the average time of radiation was (9.4±0.5) seconds. The time of left atrial geometry modeling was (7.5±4.3) minutes, the time for left pulmonary vein isolation was (55±17) minutes, and the time for right pulmonary vein isolation was (37±11) minutes, respectively.Cardiac tamponade occurred in 1 cases, which was cured after pericardial puncture. Follow-up for 6-12 months showed that in 3 cases (11.5%) the AF recurred. Conclusion A steerable sheath is effective and safe during CPVI for AF ablation.

Key words: atrial fibrillation, radiofrequency ablation, steerable sheath

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