Carto XP/Carto3与常规标测指导下消融特发性右室流出道室性早搏的比较

邓盛荣; 舒茂琴; 宋治远; 钟理; 周杨

doi:10.16016/j.1000-5404.201608106

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Carto XP/Carto3与常规标测指导下消融特发性右室流出道室性早搏的比较

基础医学 | 更新时间：2026-01-09

- Carto XP/Carto3与常规标测指导下消融特发性右室流出道室性早搏的比较
- Radiofrequency catheter ablation for idiopathic premature ventricular contraction originating in the right outflow tract: a comparative study in guidance of routine mapping or Carto XP/Carto3 electro-anatomic mapping system
- 第三军医大学学报 2017年39卷第3期页码：265-270
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201608106
  中图分类号：
- 收稿：2016-08-20，
  
  纸质出版：2017-01-15
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邓盛荣, 舒茂琴, 宋治远, 等. Carto XP/Carto3与常规标测指导下消融特发性右室流出道室性早搏的比较[J]. 第三军医大学学报, 2017,39(3):265-270.

Shengrong Deng, Maoqin Shu, Zhiyuan Song, et al. Radiofrequency catheter ablation for idiopathic premature ventricular contraction originating in the right outflow tract: a comparative study in guidance of routine mapping or Carto XP/Carto3 electro-anatomic mapping system[J]. Journal of Third Military Medical University, 2017, 39(3): 265-270.
邓盛荣, 舒茂琴, 宋治远, 等. Carto XP/Carto3与常规标测指导下消融特发性右室流出道室性早搏的比较[J]. 第三军医大学学报, 2017,39(3):265-270. DOI： 10.16016/j.1000-5404.201608106.

Shengrong Deng, Maoqin Shu, Zhiyuan Song, et al. Radiofrequency catheter ablation for idiopathic premature ventricular contraction originating in the right outflow tract: a comparative study in guidance of routine mapping or Carto XP/Carto3 electro-anatomic mapping system[J]. Journal of Third Military Medical University, 2017, 39(3): 265-270. DOI： 10.16016/j.1000-5404.201608106.

摘要

Abstract

Objective

To investigate the efficacy and safety of radiofrequency catheter ablation (RFCA) guided by routine mapping or the 3-dimensional electro-anatomic mapping system (Carto XP/Carto3 electro-anatomic mapping) on idiopathic premature ventricular contraction (PVC) originating from the right ventricular outflow tract (RVOT).

Methods

A retrospective study was carried out on 144 PVC patients who underwent RFCA in our department from March 2013 to October 2015. Thirty-six patients were guided by routine mapping

and the other 108 cases by Carto XP/Carto3 electro-anatomic mapping. The mapping time

ablation time

fluoroscopic time and total procedure time were compared between the routine mapping group and Carto XP/Carto3 electro-anatomic mapping group. The levels of C reactive protein (CRP)

cardiac troponin Ⅰ (cTnⅠ) and creatine kinase-MB (CK-MB) were detected before RFCA

and in 1 and 7 d after RFCA in both groups. The efficacy was observed in 1 and 3 months of follow-up.

Results

The Carto XP/Carto3 electro-anatomic mapping group had significantly shorter mapping time

ablation time

fluoroscopic time and total procedure time of RFCA

and lower levels of CRP

cTnⅠ and CK-MB

when compared with the routine mapping group (all

0.01). The immediate success rate was 94.4% (34/36) in the routine mapping group

and was 100% (108/108) in the Carto XP/Carto3 electro-anatomic mapping group

with obvious difference between the 2 groups. At 1 month after RFCA

3 of 34 patients in the routine mapping group had recurrence of arrhythmias

but no such patient was found in the Carto XP/Carto3 electro-anatomic mapping group. At 3 months after RFCA

no recurrence of arrhythmias was observed in both groups.

Conclusion

Compared with routine mapping

Carto XP/Carto3 electro-anatomic mapping is safer

and more accurate and effective in mapping. But routine mapping has comparatively high success rate and relatively low operation cost

and is still a viable option for the patients with economic difficulties.

关键词

Keywords

references

Aliot E M Stevenson W G Almendral-Garrote J M EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias Heart Rhythm 2009 6 6 886 933 10.1016/j.hrthm.2009.04.030 Aliot E M, Stevenson W G, Almendral-Garrote J M, et al. EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias[J]. Heart Rhythm, 2009, 6(6): 886-933. DOI: 10.1016/j.hrthm.2009.04.030

Pedersen C T Kay G N Kalman J EHRA/HRS/APHRS expert consensus on ventricular arrhythmias Heart Rhythm 2014 11 10 10.1016/j.hrthm.2014.07.024 Pedersen C T, Kay G N, Kalman J, et al.EHRA/HRS/APHRS expert consensus on ventricular arrhythmias [J]. Heart Rhythm, 2014, 11(10): e166-e196. DOI: 10.1016/j.hrthm.2014.07.024

Kim R J Iwai S Markowitz S M Clinical and electrophysiological spectrum of idiopathic ventricular outflow tract arrhythmias J Am Coll Cardiol 2007 49 20 2035 2043 10.1016/j.jacc.2007.01.085 Kim R J, Iwai S, Markowitz S M, et al. Clinical and electrophysiological spectrum of idiopathic ventricular outflow tract arrhythmias[J].J Am Coll Cardiol, 2007, 49(20): 2035-2043. DOI: 10.1016/j.jacc.2007.01.085

Liang J J Huang H Huang C X Same ablation may be used for frequent premature ventricular contractions and supraventricular tachycardia Med Hypotheses 2009 73 5 818 820 10.1016/j.mehy.2009.03.046 Liang J J, Huang H, Huang C X, et al. Same ablation may be used for frequent premature ventricular contractions and supraventricular tachycardia[J]. Med Hypotheses, 2009, 73(5): 818-820. DOI: 10.1016/j.mehy.2009.03.046

Dixit S Gerstenfeld E P Callans D J Electrocardiographic patterns of superior right ventricular outflow tract tachycardias: distinguishing septal and freewall sites of origin J Cardiovasc Electrophysiol 2003 14 1 1 7 10.1046/j.1540-8167.2003.02404.x Dixit S, Gerstenfeld E P, Callans D J, et al. Electrocardiographic patterns of superior right ventricular outflow tract tachycardias: distinguishing septal and freewall sites of origin[J].J Cardiovasc Electrophysiol, 2003, 14(1): 1-7.DOI: 10.1046/j.1540-8167.2003.02404.x

舒茂琴钟理冉擘力流出道室性早搏/室性心动过速的导管消融疗效及体表心电图特征分析中华心律失常学杂志 2012 16 5 352 356 10.3760/cma.j.issn.1007-6638.2012.05.008 舒茂琴, 钟理, 冉擘力, 等.流出道室性早搏/室性心动过速的导管消融疗效及体表心电图特征分析[J].中华心律失常学杂志, 2012, 16(5): 352-356.DOI: 10.3760/cma.j.issn.1007-6638.2012.05.008

De Ponti R Ho S Y Mapping of right ventricular outflow tract tachycardia ectopies: activation mapping versus pace mapping Heart Rhythm 2008 5 3 345 347 10.1016/j.hrthm.2007.11.017 De Ponti R, Ho S Y. Mapping of right ventricular outflow tract tachycardia ectopies: activation mapping versus pace mapping[J].Heart Rhythm, 2008, 5(3): 345-347.DOI: 10.1016/j.hrthm.2007.11.017

Seidl K Schumacher B Hauer B Radiofrequency catheter ablation of frequent monomorphic ventricular ectopic activity J Cardiovasc Electrophysiol 1999 10 7 924 934 10.1111/jce.1999.10.issue-7 Seidl K, Schumacher B, Hauer B, et al.Radiofrequency catheter ablation of frequent monomorphic ventricular ectopic activity[J]. J Cardiovasc Electrophysiol, 1999, 10(7): 924-934.

Ito S Tada H Naito S Development and validation of an ECG algorithm for identifying the optimal ablation site for idiopathic ventricular outflow tract tachycardia J Cardiovasc Electrophysiol 2003 14 12 1280 1286 10.1046/j.1540-8167.2003.03211.x Ito S, Tada H, Naito S, et al. Development and validation of an ECG algorithm for identifying the optimal ablation site for idiopathic ventricular outflow tract tachycardia [J]. J Cardiovasc Electrophysiol, 2003, 14(12) : 1280-1286.

Tanner H Wolber T Schwick N Electrocardiographic pattern as a guide for management and radiofrequency ablation of idiopathic ventricular tachycardia Cardiology 2005 103 1 30 36 10.1159/000081849 Tanner H, Wolber T, Schwick N, et al.Electrocardiographic pattern as a guide for management and radiofrequency ablation of idiopathic ventricular tachycardia [J]. Cardiology, 2005, 103(1) : 30-36. DOI: 10.1159/000081849

郭涛肖践明韩明华起搏标测在心室内消融靶点定位中的应用昆明医学院学报 2003 24 1 32 35 http://www.cnki.com.cn/Article/CJFDTOTAL-KMYX200301013.htm 郭涛, 肖践明, 韩明华, 等.起搏标测在心室内消融靶点定位中的应用[J].昆明医学院学报, 2003, 24 (1): 32-35.

刘天骄方冬平郭成军应用Carto 3电解剖标测系统指导射频消融治疗室性心律失常中国心脏起搏与心电生理杂志 2013 27 2 134 137 10.7695/zgxzqb201302009 刘天骄, 方冬平, 郭成军, 等.应用Carto 3电解剖标测系统指导射频消融治疗室性心律失常[J].中国心脏起搏与心电生理杂志, 2013, 27(2): 134-137.DOI: 10.7695/zgxzqb201302009

舒茂琴冉擘力钟理 CARTO标测指导大折返性房性心动过速导管消融的临床疗效分析第三军医大学学报 2012 34 4 341 346 10.16016/j.1000-5404.2012.04.005 舒茂琴, 冉擘力, 钟理, 等. CARTO标测指导大折返性房性心动过速导管消融的临床疗效分析[J].第三军医大学学报, 2012, 34(4): 341-346. DOI: 10.16016/j.1000-5404.2012.04.005

Khaykin Y Oosthuizen R Zarnett L CARTO-guided VS NavX-guided pulmonary vein antrum isolation and pulmonary vein antrum isolation performed without 3-D mapping: effect of the 3-D mapping system on procedure duration and fluoroscopy time J Interv Card Electrophysiol 2011 30 3 233 240 10.1007/s10840-010-9538-9 Khaykin Y, Oosthuizen R, Zarnett L, et al. CARTO-guided VS NavX-guided pulmonary vein antrum isolation and pulmonary vein antrum isolation performed without 3-D mapping: effect of the 3-D mapping system on procedure duration and fluoroscopy time[J].J Interv Card Electrophysiol, 2011, 30(3): 233-240. DOI: 10.1007/s10840-010-9538-9

Valdigem B P Pereira F B da Silva N J Ablation of ventricular tachycardia in chronic chagasic cardiomyopathy with giantbasal aneurysm: Carto sound. CT. and MRI merge Circ Arrhythm Electrophysiol 2011 4 1 112 114 10.1161/CIRCEP.110.957571 Valdigem B P, Pereira F B, da Silva N J, et al. Ablation of ventricular tachycardia in chronic chagasic cardiomyopathy with giantbasal aneurysm: Carto sound. CT. and MRI merge[J].Circ Arrhythm Electrophysiol, 2011, 4(1): 112-114. DOI: 10.1161/CIRCEP.110.957571

Chinushi M Aizawa Y Takahashi K Morphological variation of nonreentrant idiopathic ventricular tachycardia originating from the right ventricular outflow tract and effect of radiofrequency lesion Pacing Clin Electrophysiol 1997 20 2Pt1 325 336 https://www.researchgate.net/publication/14152751_Morphological_Variation_of_Nonreentrant_Idiopathic_Ventricular_Tachycardia_Originating_from_the_Right_Ventricular_Outflow_Tract_and_Effect_of_Radiofrequency_Lesion Chinushi M, Aizawa Y, Takahashi K, et al. Morphological variation of nonreentrant idiopathic ventricular tachycardia originating from the right ventricular outflow tract and effect of radiofrequency lesion[J]. Pacing Clin Electrophysiol, 1997, 20 (2Pt1): 325-336.

Lambs J Redfearn D P Michael K A Radiofrequency catheter ablation for the treatment of idiopathic premature ventricular contractions originating from the right ventricular outflow tract: a systematic review and meta analysis Pacing Clin Electrophysiol 2014 37 1 73 78 10.1111/pace.12243 Lambs J, Redfearn D P, Michael K A, et al. Radiofrequency catheter ablation for the treatment of idiopathic premature ventricular contractions originating from the right ventricular outflow tract: a systematic review and meta analysis[J].Pacing Clin Electrophysiol, 2014, 37(1): 73-78. DOI: 10.1111/pace.12243

苑洪涛王玉堂单兆亮三维电解剖标测与常规标测指导射频消融治疗特发性右室流出道室早的比较中国医刊 2010 45 5 26 28 10.3969/j.issn.1008-1070.2010.05.007 苑洪涛, 王玉堂, 单兆亮, 等.三维电解剖标测与常规标测指导射频消融治疗特发性右室流出道室早的比较[J].中国医刊, 2010, 45(5): 26-28. DOI: 10.3969/j.issn.1008-1070.2010.05.007

Wijnmaalen A P Delgado V Schalij M J Beneficial effects of catheter ablation on left ventricular and right ventricular function in patients with frequent premature ventricular contractions and preserved ejection fraction Heart 2010 96 16 1275 1280 10.1136/hrt.2009.188722 Wijnmaalen A P, Delgado V, Schalij M J, et al. Beneficial effects of catheter ablation on left ventricular and right ventricular function in patients with frequent premature ventricular contractions and preserved ejection fraction[J]. Heart, 2010, 96(16): 1275-1280.DOI: 10.1136/hrt.2009.188722

Katritsis D G Zareba W Camm A J Nonsustained ventricular tachycardia J Am Coll Cardiol 2012 60 20 1993 2004 10.1016/j.jacc.2011.12.063 Katritsis D G, Zareba W, Camm A J. Nonsustained ventricular tachycardia[J].J Am Coll Cardiol, 2012, 60(20): 1993-2004. DOI: 10.1016/j.jacc.2011.12.063

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