| Objective:Retrospective analysis and evaluation of application Dyna CT Cardiac technology rotating left atrium imaging three-dimensional reconstruction of left atrium and pulmonary vein, and real-time image superposition of arbitrary Angl e fusion of perspective, combined with electrical dissection Carto standard mea suring guide line of annulus electric anatomical pulmonary vein isolation metho d early experience and clinical curative effect for the treatment of atrial fibrilla tion.Methods:Choose between April 2011 and September 2011 in guizhou province people’s hospital heart line ring electric anatomical pulmonary vein isolation w ith radiofrequency ablation treatment of 81 cases of patients with atrial fibrillati on.The pure guided by Carto 29 cases of operated patients(group A), paroxys mal atrial fibrillation in 22 cases(75.9%), 7 cases(24.1%) of persistent atrial fibrillation;Using Dyna CT Cardiac technology combined with Carto system guid ed by 52 cases of operated patients(group B), 39 cases of paroxysmal atrial f ibrillation(75.0%), 13 cases of persistent atrial fibrillation(25.0%).Surgery met hods: ablation 52 patients in B group were applied Dyna CT Cardiac technolog y line rotation left atrium imaging three-dimensional reconstruction of left atriu m and pulmonary vein, a key cut three-dimensional isolated left atrium and pu lmonary vein image superposition and real-time heart perspective fusion and gu iding catheter ablation electrode positioning.Ablation end point for pulmonary v ein isolation ring forming two-way conduction block.For sustained atrial fibrillat ion, if necessary, add line department, mitral valve ring spondylolysis and the bottom of the left atrial, left atrial rupture potential ablation, melting and tricus pid ring spondylolysis.After 1, 3, 6 months and later once every six months re gular follow-up, ask patients symptoms, line 12 lead electrocardiogram(ECG),e chocardiography before and after the determination of left atrium diameter(LA D) and left ventricular ejection fraction(LVEF), brain natriuretic peptide(BNP)or amino terminal brain natriuretic peptide precursor(NT- pro BNP) concentra tion changes of three indicators. The success rate of operation was observed, t he recurrence rate and complications.Results:two groups of patients with atrial fibrillation radiofrequency ablation en d electrical dissection isolation treatment of surgery, the average surgery time o f group A(214.32±44.68)min, X-ray exposure time(38.14±3.06)min. Group B average operation time(186.28±36.72)min, X-ray exposure time(26.48±3.21)min.Average follow-up time of group A after 20 months, 41.4% of the total su ccess rate of surgery(12 cases), the recovery of 75.9%(22 cases), 24.1% of t he total failure rates(7 cases), paroxysmal af operation success rate 45.5%(10cases), the recovery of 77.3%(17 cases), persistent atrial fibrillation operation success rate of 28.6%(2 cases), the recovery of 71.4%(5 cases); Group B a verage follow-up time of 19 months, 73.1% of the total success rate of surger y(38 cases), the recovery of 92.3%(48 cases), 7.7% of the total operation fai lure(4 cases), with paroxysmal atrial fibrillation surgical success rate 74.4%(29 cases) %, the recovery of 94.8%(37 cases), persistent atrial fibrillation opera tion success rate of 69.2%(9 cases), the recovery of 84.6%(11 cases). Group B its operation time, X-ray exposure time, total surgical success rate and the recovery, the operative success rate of paroxysmal atrial fibrillation were the gr oup A statistically significant(< 0.05), persistent atrial fibrillation operation suc cess rate no statistical differences(> 0.05); After 1, 3, 6 months and later onc e every six months regular follow-up, no significant complications occurred, the recurrence rate group A comparison group B 10.3% and 7.9%, respectively, n o statistical differences between the two.Conclusion:1.Dyna CT Cardiac technology is used to guide the atrial fibrillation radiofrequency ablation can provide performer is relatively accurate, close to t he real anatomical images, can help the performer correction and supplement o f the Carto electric anatomical images, to shorten the learning curve, the best r educe ablation surgery related complications, thus to improve the efficiency of the operation, the success rate and safety.2.Dyna CT Cardiac technology combin ed with Carto system in comparison with the simple use of Carto system, is a dvantageous to the af ablation to shorten operation time, reduces the cast time of X-ray exposure at the same time, improve the success rate of surgery. |
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