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1、磁导航指导下房颤导管消融并发症分析,无锡市人民医院 王如兴,患者资料,病例：131例磁导航指导下房颤导管消融患者；性别：男82例，女49例；年龄：58.010.7（19-78）岁；房颤类型：阵发性91例，持续性31例和永久性9例。,房间隔穿刺,方法,方法,肺静脉造影,磁消融导管放置与固定,方法,磁导航系统进入导航位,方法,7,术者进入控制室,方法,打开磁导航系统,方法,点击鼠标左房建模,方法,方法,点击界面快捷菜单,标出LSPV,方法,标出LIPV,方法,标出LIPV后左侧建模,方法,标出RSPV,方法,标出RIPV后右侧建模,方法,完成左房建模,Carto,MNS,方法,左房后壁消融,Car
2、to,MNS,方法,左房顶部线性消融,方法,二尖瓣峡部线性消融,方法,131例患者并发症发生情况,死亡 0（例）心脏穿孔和心包填塞 0（例）血栓栓塞 0（例）肺静脉狭窄 0（例）血胸和气胸 2（例）无症状脑栓塞 1（例）出血血肿 0（例）其他 1（例）,血胸2例,锁骨下穿刺所致,无症状脑栓塞1例,Pre-procedure,Post-procedure,颈背部出血1例,抗凝药物所致的自发性出血？,并发症分析,Which one is better?,Magnetic,Manual,2013年Europace荟萃分析,PV Isolation,AF recurrence,Major compli
3、cations,心脏穿孔和心包填塞,肺静脉狭窄,磁导航 vs.压力导管-安全性,1Shurrab,et al.Int J Cardiol.2013 Nov 5;169(3):157-65,2Stereotaxis Efficiency Study MR-14-001,3Sciarra,et al.J Interv Card Electrophysiol.2014 Feb 21.Epub ahead of print,4Stabile,et al.Europace.2014 Mar;16(3):335-40.,5Marijon,et al.J Cardiovasc Electrophysiol,
4、Vol.25,pp.130-137,6Natale,et al.SMART-AF Trial.2012 HRS LBT 02-03,7Martinek,et al.Pacing Clin Electrophysiol.2012 Nov;35(11):1312-8.,8Waliki,et al.Clin Res Cardiol.2014 Feb;103(2):97-106,9Reddy,et al.Heart Rhythm 2012;9:1789 1795,The largest such study reported an SCL incidence of 14.2%using open ir
5、rigation RF catheters.,无症状脑栓塞,Herrera Sikldy C et al.J Am Coll Cardiol.(2011),出血和血肿,Aagaard P,et al.Robotic navigation.for catheter ablation benefits and challenges.Expert Rev Med Devices 2015;12:457-469.,安全性,J Interv Card Electrophysiol 2015;44:1-8.,疗效好：稳定的贴靠,疗效好：有效的消融损伤,J Interv Card Electrophysio
6、l 2015;44:1-8.,磁导航 vs.压力导管-疗效,1Shurrab,et al.Int J Cardiol.2013 Nov 5;169(3):157-65,2Stereotaxis Efficiency Study MR-14-001,3Sciarra,et al.J Interv Card Electrophysiol.2014 Feb 21.Epub ahead of print,4Stabile,et al.Europace.2014 Mar;16(3):335-40.,5Marijon,et al.J Cardiovasc Electrophysiol,Vol.25,pp.
7、130-137,6Natale,et al.SMART-AF Trial.2012 HRS LBT 02-03,7Martinek,et al.Pacing Clin Electrophysiol.2012 Nov;35(11):1312-8.,8Waliki,et al.Clin Res Cardiol.2014 Feb;103(2):97-106,9Reddy,et al.Heart Rhythm 2012;9:1789 1795,磁导航 vs.压力导管-曝光时间,1Shurrab,et al.Int J Cardiol.2013 Nov 5;169(3):157-65,2Stereota
8、xis Efficiency Study MR-14-001,3Sciarra,et al.J Interv Card Electrophysiol.2014 Feb 21.Epub ahead of print,4Stabile,et al.Europace.2014 Mar;16(3):335-40.,5Marijon,et al.J Cardiovasc Electrophysiol,Vol.25,pp.130-137,6Natale,et al.SMART-AF Trial.2012 HRS LBT 02-03,7Martinek,et al.Pacing Clin Electrophysiol.2012 Nov;35(11):1312-8.,8Waliki,et al.Clin Res Cardiol.2014 Feb;103(2):97-106,9Reddy,et al.Heart Rhythm 2012;9:1789 1795,小 结,并发症少zero complications 疗效好医患暴露X线的时间和剂量少学习曲线短,磁导航指导下心房颤动的导管消融能否完全代替手工消融？,Thank Youfor your attention!,
