[1]陶海龙),龙德勇),赵江涛),等.心腔内超声三维标测指导下经皮射频消融室间隔治疗肥厚型梗阻性心肌病[J].郑州大学学报(医学版),2019,(06):899-902.[doi:10.13705/j.issn.1671-6825.2019.04.034]
 TAO Hailong),LONG Deyong),ZHAO Jiangtao),et al.Radiofrequency ablation of interventricular septum to treat hypertrophic obstructive cardiomyopathy with CARTOSound technology[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2019,(06):899-902.[doi:10.13705/j.issn.1671-6825.2019.04.034]
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心腔内超声三维标测指导下经皮射频消融室间隔治疗肥厚型梗阻性心肌病()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2019年06期
页码:
899-902
栏目:
应用研究
出版日期:
2019-11-20

文章信息/Info

Title:
Radiofrequency ablation of interventricular septum to treat hypertrophic obstructive cardiomyopathy with CARTOSound technology
作者:
陶海龙1)龙德勇2)赵江涛1)朱 揆1)陈英伟1)陈晓杰1)董建增12)
1)郑州大学第一附属医院心内科 郑州 450052 2)首都医科大学北京安贞医院心内科 北京100029
Author(s):
TAO Hailong1) LONG Deyong2) ZHAO Jiangtao1) ZHU Kui1) CHEN Yingwei1) CHEN Xiaojie1) DONG Jianzeng12)
1)Cardiovascular Department, the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052 2)Cardiovascular Department,Anzhen Hospital,Capital Medical University,Beijing 100029
关键词:
心腔内超声 三维标测 射频消融 肥厚型梗阻性心肌病
Keywords:
intracardiac echocardiography three-dimensional mapping radiofrequency ablation hypertrophic obstructive cardiomyopathy
分类号:
R541
DOI:
10.13705/j.issn.1671-6825.2019.04.034
摘要:
目的:探讨心腔内超声三维标测指导下射频消融室间隔治疗肥厚型梗阻性心肌病的安全性及疗效。方法:20例肥厚型梗阻性心肌病患者,应用心腔内超声三维标测技术重建左心室腔,以收缩期二尖瓣瓣叶前向运动(SAM)对应的左室间隔部位作为消融靶点,消融能量35 W,冷盐水灌注流速17 mL/min,温度43 ℃,每次放电时间40~60 s。以左室流出道压差下降50%作为消融有效终点。比较术前、术后左室流出道压差及6 min步行试验结果,记录围术期并发症发生情况,评价疗效和安全性。结果:消融前室间隔厚度(20.3±1.9)mm,左室流出道压差(106.0±36.5)mmHg(1 mmHg=0.133 kPa),6 min步行试验(404.2±25.6)m。消融放电(5.6±0.9)次,左室流出道压差降至(44.0±35.2)mmHg,术中一过性左束支传导阻滞3例。术后6个月随访,左室流出道压差(28.4±12.9)mmHg,6 min步行试验(525.0±25.2)m,较消融前明显改善(P<0.001)。结论: 经心腔内超声指导下室间隔射频消融术治疗肥厚型梗阻性心肌病安全、有效。
Abstract:
Aim:To evaluate the efficacy and security of radiofrequency ablation of the interventricular septum to treat hypertrophic obstructive cardiomyopathy with CARTOSound technology.Methods:Twenty patients with hypertrophic obstructive cardiomyopathy were observed. With the guidance of intracardiac echocardiography, left ventricular chamber was reconstructed. The mitral valve systolic anterior motion contacting septal area was annotated on the ventricular chamber and was targeted for ablation region. Ablation energy was 35 W, flow rate of cold brine infusion was 17 mL/min,the temperature was 43 ℃,and the discharging time was 40-60 s per time.A gradient reduction of >50% was designed as therapeutic end point. Echocardiography examination(gradient reduction)and six-min walk test were performed at 6 months after ablation.Results:Before ablation, septal thickenss was(20.3±1.9)mm, the left ventricular gradient reduction was(106.0±36.5)mmHg, six-min walk test was(404.2±25.6)m. After(5.6±0.9)radiofrequency release, left ventricular gradient reduction was decreased to(44.0±35.2)mmHg. Three patients experienced left bundle branch transit block. The follow-up at 6 months after ablation showed that left ventricular gradient reduction was(28.4±12.9)mmHg, and six-min walk test was(525.0±25.2)m, both were improved(P<0.001).Conclusion:Radiofrequency ablation of the interventricular septum to treat hypertrophic obstructive cardiomyopathy with CARTOSound technology is effective and safe.

参考文献/References:

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备注/Memo

备注/Memo:
【作者简介】陶海龙,男,1976年5月生,博士,副教授,副主任医师,研究方向:复杂心律失常的机制和介入治疗,E-mail:hailongtao@163.com
更新日期/Last Update: 2019-11-20