Clinical Study on Radiofrequency Ablation for Complicated Arrhythmia Guided by Intracardiac Noncontact Catheter Mapping System / 昆明医科大学学报

ABSTRACT

Objective To evaluate the efficacy and superiority of intracardiac noncontact catheter mapping system for mapping and ablation of complicated arrhythmia.Methods 12 patients(9 males and 3 females,aged between 28 and 76 years) were included in this study.The characteristics of electrophysiological examination were as follows one was idiopathic ecotopic beats originated in right ventricular outflow tract(RVOT),two cases with idiopathic left ventricular tachycardia(ILVT),one atrial tachycardia(AT) of left atrium,two AT originated in right atrium,six atrial fibrillation(Afi) of left atrium.Among them,4 cases failed with conventional electrophysiological examination and radio frequency ablation(RFA),1 patient was reported recurrence.All patients were introduced 64 non-contact unipolar electrodes and ablation catheter to the same chamber via formal veins,reconstructed three-dimension geometry configuration,isopotential maps and analyzed the foci of reentrant activation and critical isthmus,then ablated the interested sites guided by noncontact mapping system.Results One idiopathic ectopic beat originated in RVOT near septum received segmental ablation.Two ILVT substrates located at left posterior-mid septum and left-posterior septum underwent segmental ablation.One AT of left atrium(LA) originated in right inferior pulmonary vein(RIPV) was given linear ablation between RIPV and mitral.One of the two AT from right atrium(RA) mapped the earliest activation in orifice of inferior cava vein and was given cricoid ablation;another AT originated in posterior wall of superior cava vein across crista terminal received linear lesion.One of the six Afi cases triggered by left atrial ectopic beats was given linear lesion between left superior pulmonary vein(LSPV) and right superior pulmonary vein(RSPV) during sinus rhythm;the other five cases mapped the reentrant origin site of Afi during persistent Afi rhythm received the catheter linear ablation,and the ablation lines respectively were created between RSPV and RIPV,LSPV and left inferior pulmonary vein(LIPV),LSPV and RSPV,LIPV and mitral isthmus.All patients succeeded and no obvious complication observed in operation and postoperation.None recurred during 2~26 month follow-up period.Conclusions It is safe and effective of intracardiac noncontact catheter mapping system for endocardium mapping and ablation of arrhythmia,especially for the clarity of electrophysiological mechanism of complicated arrhythmia and guiding RAF,which has potential clinical values.