应用STSF导管高功率消融模式治疗老年阵发性房颤的临床疗效

doi:10.3969/j.issn.1000-8535.2022.04.003

广州医药 ›› 2022, Vol. 53 ›› Issue (4): 9-13.DOI: 10.3969/j.issn.1000-8535.2022.04.003

应用STSF导管高功率消融模式治疗老年阵发性房颤的临床疗效

孙少喜, 谭文亮, 黎镇赐, 吴天源

广州市第一人民医院心内科 (广州 510180)

收稿日期:2021-11-27 出版日期:2022-07-20 发布日期:2022-08-03
通讯作者: 孙少喜,E-mail:sunshaoxi83@163.com
基金资助:
广州市卫生健康科技项目(20191A011011)

Clinical efficacy of STSF catheter high-power ablation mode in the treatment of elderly patients with paroxysmal atrial fibrillation

SUN Shaoxi, TAN Wenliang, LI Zhenci, WU Tianyuan

Department of Cardiology, Guangzhou First People's Hospital, Guangzhou 510180,China

Received:2021-11-27 Online:2022-07-20 Published:2022-08-03

摘要/Abstract

摘要： 目的探讨应用56孔冷盐水(STSF)压力导管高功率消融模式治疗老年阵发性房颤患者的有效性和围手术期安全性。方法回顾性分析广州市第一人民医院2019年1月—2021年6月使用STSF导管高功率消融模式行射频治疗的老年阵发性房颤患者68例(STSF组),匹配同期年龄、性别、左房直径、左室射血分数无差异且使用6孔冷盐水 (ST)压力导管常规功率消融的老年房颤患者71例(ST组),比较2组患者之间的即刻环肺静脉隔离成功率、单圈隔离成功率、手术时间、X线透视时间、消融时间、术中盐水灌注量,以及并发症发生率。结果 2组患者都成功完成环肺静脉电隔离,STSF组单圈隔离成功率与ST组无差异(左侧肺静脉92.6% vs 90.1%,P>0.05;右侧肺静脉83.8% vs 87.3%,P>0.05),与ST组比较,STSF组手术及消融时间缩短[(70.9±10.0)min vs (79.1±14.2)min,P<0.001;(25.4±4.5)min vs(30.5±6.3)min,P<0.001],灌注量更低[(406.5±46.3)mL vs (729.2±106.1)mL;P<0.001],X线透视时间相近[(6.5±2.5)min vs(7.3±2.6)min;P=0.056]。2组围手术期并发症率均较低(2.9% vs 3.9%;P=0.39),STSF组2例术中发生气体爆破,但未引起心包填塞,ST组有2例术后出现心衰,利尿后好转,1例出现持续性胸痛,胃镜提示食道糜烂,予流质饮食及质子泵抑制剂治疗后恢复。结论应用STSF导管高功率消融模式在老年阵发性房颤患者行肺静脉大环隔离可提高消融效率,减少术中液体负荷,且不增加围手术期风险。

关键词: 心房颤动, 射频消融, 高功率, SFSF导管

Abstract: Objective To investigate the effectiveness and perioperative safety of ThermoCool SmartTouch SurroundFlow (STSF) catheter high-power ablation mode in the treatment of elderly patients with paroxysmal atrial fibrillation. Methods A total of 68 elderly patients with paroxysmal atrial fibrillation who used STSF catheter high-power ablation mode (STSF group) in Guangzhou First People's Hospital from January 2019 to June 2021 were analyzed retrospectively. There were 71 elderly patients with atrial fibrillation who had no significant difference in age, sex, left atrial diameter and left ventricular ejection fraction, used ThermoCool SmartTouch (ST) catheters for conventional power ablation (ST group) at the same time. The success rate of immediate circumferential pulmonary vein isolation, single lap isolation, operation time, X-ray fluoroscopy time, ablation time, intraoperative saline perfusion volume and the incidence of complications were compared between the two groups. Results Both groups of patients successfully completed circular pulmonary vein electrical isolation. There was no significant difference in the success rate of single-circle isolation between STSF group and ST group (left pulmonary vein 92.6% vs 90.1%, P>0.05; right pulmonary vein 83.8% vs 87.3%, P>0.05). Compared with ST group, STSF group had shorter operation and ablation time [(70.9±10.0) min vs (79.1±14.2) min, P<0.001; (25.4±4.5) min vs (30.5±6.3) min, P<0.001], lower perfusion volume [(406.5±46.3)mL vs (729.2±106.1)mL, P<0.001], similar X-ray fluoroscopy time [(6.5±2.5)min vs (7.3±2.6)min, P=0.056 ]. The perioperative complication rate of the two groups was low (2.9% vs 3.9%, P=0.39). Two cases of STSF group had steam pops during operation but did not cause pericardial tamponade, and 2 cases of ST group had postoperative heart failure occurred and improved after diuresis. One case developed persistent chest pain, which gastroscope indicated esophageal erosion, and recovered after liquid diet and PPI treatment. Conclusions Using STSF catheter high-power ablation mode to perform pulmonary vein isolation in elderly patients with paroxysmal atrial fibrillation could improve ablation efficiency, reduce intraoperative fluid load, and without increasing perioperative risk.

Key words: atrial fibrillation, radiofrequency ablation, high-power, ThermoCool SmartTouch SurroundFlow catheter

孙少喜, 谭文亮, 黎镇赐, 吴天源. 应用STSF导管高功率消融模式治疗老年阵发性房颤的临床疗效[J]. 广州医药, 2022, 53(4): 9-13.

SUN Shaoxi, TAN Wenliang, LI Zhenci, WU Tianyuan. Clinical efficacy of STSF catheter high-power ablation mode in the treatment of elderly patients with paroxysmal atrial fibrillation[J]. Guangzhou Medical Journal, 2022, 53(4): 9-13.

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应用STSF导管高功率消融模式治疗老年阵发性房颤的临床疗效

Clinical efficacy of STSF catheter high-power ablation mode in the treatment of elderly patients with paroxysmal atrial fibrillation

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