压力监测下导管射频消融与非压力导管射频消融治疗RVOT-VAs的疗效及安全性比较

doi:10.3969/j.issn.1006-6233.2021.08.021

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摘要 目的: 比较压力监测下导管射频消融与非压力导管射频消融治疗右心室流出道室性心律失常(RVOT-VAs)的临床疗效及安全性。方法: 选取2016年6月至2021年3月在本院拟接受射频消融治疗的RVOT-VAs患者309例,简单随机分组法分为压力组(n=167)与非压力组(n=142)。压力组患者接受ThermoCool SmartTouch压力监测下高功率导管射频消融治疗,非压力组患者接受Navistar ThermoCool冷盐水灌注消融导管射频消融治疗。比较两组患者的手术指标、消融成功率、术后并发症及复发情况。结果: 压力组患者的手术时间、消融放电时间和X线曝光时间明显短于对照组,无效放电次数明显少于对照组(P<0.05);压力组患者术后消融成功率均高于非压力组(P<0.05);术后,压力组的并发症合计发生率、复发率和再次消融率均低于非压力组(P<0.05)。结论: 压力监测下导管射频消融在治疗RVOT-VAs方面具有良好的临床疗效,可明显缩短手术时间、消融放电时间和X线曝光时间,且术后并发症发生率及复发率较低,远期消融成功及安全性优于非压力导管射频消融。

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关键词 ：右心室流出道室性心律失常, 射频消融, 压力监测, 电生理学

Abstract：Objective: To compare the clinical effects and safety of radiofrequency catheter ablation under pressure monitoring and pressure-independent radiofrequency catheter ablation in the treatment of right ventricular outflow tract ventricular arrhythmias(RVOT-VAs). Methods: From June 2016 to March 2021, 309 patients with RVOT-VAs scheduled to be treated with radiofrequency ablation were selected and randomly divided into pressure group (n=167) and non-pressure group (n=142). Patients in the pressure group underwent high-power ThermoCool SmartTouch catheter radiofrequency ablation under pressure monitoring, while patients in the non-pressure group underwent NaviStar ThermoCool saline-irrigated catheter radiofrequency ablation. The operation indicators, success rate of ablation, postoperative complications and recurrence rate were compared between the two groups. Results: The operation time, ablation discharge time and X-ray exposure time of the pressure group were significantly shorter than those of the control group, and the number of invalid discharges was significantly smaller than that of the control group(P<0.05). The success rate of ablation after operation in the pressure group was higher than that in the non-pressure group (P<0.05). After operation, the total incidence of complications, recurrence rate and re-ablation rate in the pressure group were lower than those in the non-pressure group (P<0.05). Conclusion: Radiofrequency catheter ablation under pressure monitoring reveals good clinical effects in the treatment of RVOT-VAs. It can significantly shorten the operation time, ablation discharge time and X-ray exposure time, with a lower incidence of postoperative complications and a lower recurrence rate. The success rate and safety of long-term ablation are better than pressure-independent radiofrequency catheter ablation.

Key words： Right ventricular outflow tract ventricular arrhythmias Radiofrequency ablation Pressure monitoring Electrophysiology

基金资助:四川省医学会科研课题,(编号:S16005)

通讯作者: 刘汉雄

引用本文:

李祚灵, 裴晓玲, 林艳, 龙娇, 杨洋, 刘汉雄. 压力监测下导管射频消融与非压力导管射频消融治疗RVOT-VAs的疗效及安全性比较[J]. 河北医学, 2021, 27(8): 1330-1334.
LI Zuoling, PEI Xiaoling, LIN Yan, et al. Efficacy and Safety of Radiofrequency Catheter Ablation Under Pressure Monitoring and Pressure-Independent Radiofrequency Catheter Ablation in the Treatment of RVOT-VAs:a Comparative Study. HeBei Med, 2021, 27(8): 1330-1334.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.08.021 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I8/1330

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