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1、null null null nullCartonullMerge / 5 h ? 8 李null 易1,李绍龙1,刘null 屹1,刘兴鹏2,董建增2,刘少稳3,陶四明1.张仪坚1(1.昆明医学院第四附属医院暨云南省第二人民医院心脏内科null 650021;2.首都医科大学附属北京安贞医院心内科null 100029;3.上海市第一人民医院心内科null 200080)null null K null 1 : null 运用16排螺旋CT图像与CARTO三维电解剖标测整合技术(CartonullMerge)指导阵发性房颤的导管消融治疗bZ E null 32例经抗心律失常药物治疗效果欠佳的
2、患者进行手术,其中6例患者术前1 3d行16排CT 心脏成像检查,术前将CT 导入有CartonullMerge的软件包进行三维重建,重建后在CartonullMerge指导手术b T null 所有患者均顺利完成手术,未发生手术并发症bCartonullMerge整合误差为(1.8 0.62)mm,使用CartonullMerge患者平均手术时间为(98 28)min,X线曝光时间为(26 11)min;未使用CartonullMerge患者手术时间为(112 42)min,X线曝光时间为(35 17)minb null 使用图像融合技术可以缩短手术及X线曝光时间,提高手术的效率及安全性b1
3、 o M :导管消融;CT 心脏成像;心房颤动;图像融合技术 m s | :R541.75;R814.42 D S M :A c I | :1671null8348(2008)23null2680null03Initial experience of paroxysmal atrial fibrillation ablationguided by CartonullMergeLI Yi1,LIShaonulllong1,LIUYi1,etal.(1.Departmentof Cardiology,FourtyAf filiated Hospital of Kunming Medical Col
4、leage,Kunming,Yunnan 650021,China2.Departmentof Cardiology,Af filiated Anzhen Hospital,CapitalMedical University,Beijing 100029,China;3.Departmentof Cardiology,FirstPeople!sHospital of Shanghai,Shanghai 200080,China)Abstract:Objectivenull To investigate the effectivenessand advantages of the Cartonu
5、llMerge technique in guiding catheter ablationof paroxysmal atrialfibrillation. Methodsnull Thritynulltwo patients weretreatedand6 patientsfinished16nullslice CT image 1- 3d beforeablation.16nullslice CT scan combinedwith Carto imagewas performedby using CartonullMergesoftware and guiding ablation.R
6、esultsnullAll patients were successfully achieved the endpoint of ablation.All CartonullMerge patients with an error of (1.8 0.62)mm.Themean procedure time was(98 28)mininMerge groupand(112 42)min in nonullMerge group.The Xnullray exposed time was(26 11)min in Merge group and (35 17)min in nonullMer
7、ge group. Conclusionnull CartonullMerge technique can shorten the ablation and Xnullray exposedtime,also improve safety andeffectiveness.Key words:catheter ablation;CT image;atrialfibrillation;CartonullMerge techniquenull null (e ) 5 K n p , M , 5 h X 1 Z E , CARTO d / k - V - 5 h 1 B b ? q r 87%1bC
8、artonullMerge | # S CT B / , m V Carto m b ) / h 5 r , T 16 CT Cartom / h 8 / b1null 5 1.1null B null 4 2006 M 5 2008M 01 i s 5 h ? 32 , 3 15 ,o 17 ,M - 32 74 , ( (47.5 12.8) b # 2_ P = 28 51mm, ( (38.2 4.8)mmb 9 i a2 i U h a2 i J F ? h | b ( F p 0 r b1.2null - ! null ? U h y - ? ? F 1 , INR2 3, - 5
9、dP s 0 ) 5 000u 12l H 1Q F , - 12h T b - P F p 0 T 72h , - 1d J 2 m _ P , -INR 1.0 1.8 W b P 0 e m b E CartonullMerge h - 1 3d16 CT b1. 3null 16 CT null # CT P S SIEMENS 16 CT d ,5 S ,P 0 e q 50 60Q /s ,CT Z S 1 # b 3.5mL/min / 4 (Uitranullvist370,Schering,GER) 60 70mL bCT H W ! 13 17s, 4 0.5s , 1.2
10、5mm, $ e / | S m , y 3 g V RRW 5% 95% W , y W 10%, 10 M m b 4 f H M y 3 g m bCT T Y ! b1. 4null m V 1.4.1null P nullk y null ? , O b 3 , # - | (RAO)45XL i j / , O W , B SwartzG , SwartzG Y 100u/kg,N m V 30s ACT, F ACT 300350sbi 1u/mL 20mL/h ! SwartzG , G = bP - | (LAO)50# RAO30 P k / b Carto S h 5 (Thermo Cool,NavinullStar) P | P k - V y ,k - V 2680 重庆医学2008年12月第37卷第23期 + y S : b1.4.2null CTm CARTO null 6 CT _ ,| 16 CT m ! Cartonull
