背景:与冠状窦(CS)憩室相关的房间隔后辅助通路(AP)对消融来说是一个罕见且具有挑战性的问题。本研究旨在比较常规方法和三维(3D)标测系统在导管消融中的安全性和有效性。
结果:这是一项回顾性研究,对我们中心的所有患者(2013年1月至2022年7月)进行了房间隔后AP与CS憩室相关的导管消融。使用传统透视方法进行导管消融的患者被纳入常规方法组(n=13)。使用3D标测方法进行导管消融的患者被纳入3D标测组(n=11)。临床特征,消融程序,并对两组间的结局进行记录和分析.669例房间隔后APs患者中,其中24例(3.6%)与CS憩室有关。两组患者均顺利完成电生理研究。在常规方法组中,两名患者出现并发症(一名患者心包积液,另一名患者股动脉血肿),两名患者复发。然而,随访期间无患者出现并发症或复发。常规方法组的手术时间和透视时间明显长于3D标测方法组。
结论:利用3D标测可缩短透视时间,较短的程序持续时间,提高急性成功率,降低并发症发生率。
Posteroseptal accessory pathways (APs) associated with coronary sinus (CS) diverticulum present a rare and challenge for ablation. This study aimed to compare the safety and efficacy of conventional approach and three-dimensional (3D) mapping system in the catheter ablation.
This was a retrospective study of all patients (from January 2013 to July 2022) who underwent catheter ablation of posteroseptal AP associated with CS diverticula in our center. Patients who underwent catheter ablation using the traditional fluoroscopy method were included in the conventional method group (n = 13). Patients who underwent catheter ablation using the 3D mapping method were included in the 3D mapping group (n = 11). Clinical characteristics, ablation procedure, and outcomes were recorded and analyzed between the two groups. Out of 669 patients with posteroseptal APs, 24 of them (3.6%) were associated with CS diverticula. All patients in both groups successfully completed the electrophysiological study. In the conventional method group, two patients experienced complications (one patient with pericardial effusion and the other patient with femoral arterial hematoma), and two patients had recurrence. However, no patients suffered from complications or recurrence during follow-up. The procedure time and fluoroscopy time in the conventional method group were significantly longer than those in the 3D mapping method group.
The utilization of 3D mapping led to reduced fluoroscopy time, shorter procedure duration, enhanced acute success rates, and decreased incidence of complications.