摘要目的 EASTAR(ElectroAnatomic SoluTion for All Arrhythmias)是指利用三维电解剖标测(EAM)系统处理所有快速性心律失常的治疗理念.本研究通过回顾性分析,探讨利用三维EAM系统指导各种快速性心律失常导管消融治疗的可行性.方法 研究入选2009年1月至2014年t2月在宁波市第一医院心律失常诊疗中心连续收治、接受射频导管消融治疗的快速性心律失常,包括心房颤动(AF)、心房扑动(AFL)、其他房性心律失常(AA)、房室结折返性心动过速(AVNRT)、房室折返性心动过速(AVRT)、室性心律失常(VA)患者共2 666例,回顾性分析各类心律失常的年手术时间、X线曝光时间及曝光量的差异,并与非EASTAR方案的术者病例相比较.同时通过单个术者6年间的数据变化反映EASTAR方案下的学习曲线.结果 EASTAR理念下各类心律失常导管消融手术中,三维导航系统的使用比例逐年上升,并可实现全三维化.不同基质的心律失常病例年均手术时间、X线暴露时间、X线剂量均呈显著下降趋势.与传统X线指导标测及消融的非EASTAR病例比较,全三维导管消融可显著减少手术时间及X线暴露.EASTAR理念还可优化“学习曲线”,利于术者培养.结论 既往6年数据显示,EASTAR理念下全三维心律失常导管消融治疗可优化手术时间,减少射线暴露,并有利于术者培养.

abstractsObjective To investigate the feasibility of the EASTAR(ElectroAnatomic SoluTion for All Arrhythmias) principle,which was firstly advocated by our center with the analysis of six-year data.Methods Data of 2 666 consecutive patients who underwent catheter ablation therapy for tachyarrhytlnias (including atrial fibrillation,atrial flutter,other atrial tachycardias,atrioventricular nodal reentrant tachycardia,atrioventricular reentrant tachycardia,ventricular arrhythmias)from January 2009 to December 2014 were retrospectively analyzed based on the guidance of three-dimensional electroanatomic mapping systems.The feasibility of the EASTAR principle was concluded based on the variations of procedure times,fluoroscopy times and radiation doses which then compared with non-EASTAR cases.The "learning curve" was reflected by the growth of a single operator.Results The use of electroanatomic mapping increased significantly annually with the guidance of EASTAR principle.The average procedure times,fluoroscopy exposure times and radiation doses declined correspondingly despite of variant tachycardia substrates.The advantages existed when compared with non-EASTAR cases.The "learning curve"could be optimized under that principle.Conclusion Advantages in the decrement of procedure times and fluoroscopy exposure as well as the"learning curve"in the catheter ablation therapy of all tachyarrhythmias under the guidance of the EASTAR principle are confirmed based on the six-year single center's data analysis.