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1、上海交通大学医学院02级七年制硕士学位论文system(Carto,BiosenseWebster,Inc.,DiamondBar,CA,USA).Contrast-enhancedhigh-resolutionCTimagingwasperformedwithin1-3dayspriortotheablationprocedures.Usinganovelsoftwarepackage(CartoMerge,BiosenseWebster,Inc.),theleftatrium(LA)withpulmonaryveins(PVs)wassegmentedandextractedfo
2、rimageregistration.Thesegmented3DCTLAreconstructionwasaccuratelyregisteredtothereal-timemappingspacewithacombinationoflandmarkregistrationandsurfaceregistration.Theregistered3DCTLAreconstructionwassuccessfullyusedtoguidedeploymentofRFapplicationsencirclingthePVs.Inthesecondpart,thirty-ninepatie
3、ntswithsymptomatic,drugrefractoryPAFwereassignedtoCartoMergegroup(n=18,meanage(56.44±8.93)years,historyofAF=5.66years)orCartoXPgroup(n=21,meanage(53.10±12.39)TMyears,historyofAF=4.67years).UsingCartoMergeImageIntegrationModule,3Danatomicalimagesoftheleftatrium(LA)andpulmonaryveins(PVs)derivedfr
4、omMSCTofCartoMergegroupwereestablishedandmergedwiththeelectroanatomicalmap.Theintegratedimageswereusedtoguidetheprocedureofcircumferentialpulmonaryveinisolation(CPVI).Intheothergroup,CPVIwasguidedjustbyCartoXP.TheendpointofCPVIinbothgroupswasabolitionordissociationofpulmonaryveinpotentials(PVPs
5、).上海交通大学医学院02级七年制硕士学位论文ResultsForthefirststudy,theregistered3DCTLAreconstructionwassuccessfullyusedtoguidedeploymentofRFapplicationsencirclingthePVs.AllthePVsreachedisolated.Thedistancebetweenthesurfaceoftheregistered3DCTLAreconstructionandmultipleelectroanatomicmappointswas2.3±1.5mm.Andinthese
6、condone,wefoundthatMappingpointstoestablishtheelectroanatomicalmodeloftheLA/PVswere95±5.02inCartoMergegroupand87.95±4.93inCartoXPgroup(P<0.001).DurationsofprocedureandexposuretoX-raywere(237.33±43.29)minutes,(289.62±55.34)minutes(P<0.001)and(25.48±2.90)minutes,(36.03±2.89)minutes(P<0.001),respe
7、ctively.Afterafollow-upwithdurationof(11.98±3.89)monthsvs(12.78±4.09)monthspostthefirstablationprocedure,patientsfreeofAFwere15(83.33%)inCartoMergegroupand12(57.14%)inCartoXPgroup(P>0.50).ConclusionThree-dimensionalCTimagescanbesu
