生堡!坠堡去堂堂盘查!Q!!生!旦筮!!鲞筮生翅垦!也』垡!熊遮叁丛匹!：垒!匹塾垫!!：!垡：!!盟!：兰·275··临床研究·EnsiteNavX引导下无X线透视射频导管消融治疗右侧阵发性室上性心动过速刘小青周旭杨刚钟光珍石亮田颖李艳兵汪爱虎杨新春【摘要】目的探索EnsiteNavX引导下无x线透视射频导管消融治疗右侧阵发性室L性心动过速(室上速)的可行性与安全性。方法2010年6月至10月在我院接受导管射频消融治疗的右侧阵发性室上速患者20例，均无心脏血管结构异常，其中右侧房室旁路6例，房室结双径路14例。所有患者均在EnsiteNavX三维导航标测系统引导下实施完全无x线透视的心脏电生理检查和射频导管消融治疗。结果所有患者消融术成功，x线曝光时间均为0，消融术时间为65～125(100．5+20．3)rain，冠状静脉窦导管植入时间8～30(14．9+6．6)rain。所有患者没有发生消融术相关的并发症，随访15～90d无复发。结论初步经验显示EnsiteNavX引导下无x线透视射频导管消融治疗阵发性室上速安全、可行，但需大样本的病例总结、验证。【关键词】阵发性室上性心动过速；导管消融；无x线透视Nonfluoroscopicradiofrequencycatheterablationofright-sidedparoxysmalsuperventriculartachycar-diaguidedbyemiteNavXsystemLIUXiao—qing，ZHOUXu，YANG∞增，ZHONGGuang-zhen，SillLi—ang，TIANYing，LIYan-bing，WANGAi—hu，YANGXin-chun，BeijingChaoyangHospitalAffiliatedofCapitalUniversityofMedicalSciences，Beijing100020，ChinaCorrespondingauthor：YANGXin—chun，Email：yangxc99@grnaiLcorn【Abstract】ObjectiveToprobethefeasibilityandsafet)rofnonfluoroscopiccatheternavigationform-diofrequeneycatheterablationofrigllt—sidedparoxysmalsuperventriculartachycardiaguidedbyEnsiteNavXsystem．MethodsNonfluoroscopicmdiofrequencycatheterablationnavigatedbyEnsiteNavXsystemWasper-formedin20cases[meanage(53．4±16．1)yaers，range24～74years]ofright—sidedparoxysmalsuperventricu-lartachycardiawithnormalcardiacanatomy，including6caseswithriglItaccessorypathwayand14caseswithatrioventricularnodalreentranttachycardia．UsingEnsiteNavX，rightatrialandcoronarysinusgeometrieswerecreatedwithadeflectabledecapolarcatheterthroughthefemoralveins，thenthedecapolarcathterWaSplacedincoronarysinus．Quadripolarcatheterswereplacedthroughthefemoralveinsintothehighrightatrium，Hisbun-dle，andrightventrieular，respectively．Diagnosticelectrophysiologicstudyandradiofrequeneycatheterablationwereperformedinallpatientswithouttheuseoffluoroscopy．ResultsTheSUCCClSSrateofprocedureWaS100％．ThefluoroscopicexposuretimeWaszeroforeverycase．TheaverageproceduredurationWas65—125(100．5±20．3)min，thecoronarysinusaccesswasobtainedin8～30(14．9±6．6)min．Nocomplicationsoccurred．Notachycardiarcoccuredin15—90daysfollow—up．ConclusionsOurpreliminaryexperiencesuggeststhatnon-fluoroscopiccatheternavigationforradiofrequencycatheterablationofright-sidedparoxysmalsuporventriculartaehycardiaaresafeandfeasible．Futuresmdieswithlargesamplesizearenecessaryforverificationandsum-marization．【Keywords】Paroxysmalsuperventrieulartachycardia；Catheterablation；NonfluoroseopieDOI：10．3760／cma．j．issn．1007—6638．2011．04．009作者单位：100020尚‘都医科大学附属北京朝阳医院心脏中心通信作者：杨新春，Email：y∞群c99@gmaiLcorn万方数据·276·生坐!坚建塞堂堂盘盍垫!!生!旦筮!§鲞筮垒期垦!也』垦趔迪垒些地：垒!趔!!!!!!：!生：!§№：堡传统的射频导管消融治疗阵发性室上性心动过速(室上速)需要在x线引导下操作导管完成。近年来，随着三维导航技术的发展与其在临床应用经验的积累，射频导管消融治疗对x线透视的依赖已大大减少。本文旨在探讨EnsiteNavX三维导航标测系统引导下实施完全无x线透...
