摘要目的:评价光感应压力监测导管损伤指数（LSI）在阵发性心房颤动（房颤）导管消融中的指导意义。方法:连续入选2019年7月至2020年4月在桂林医学院第二附属医院住院，首次同意行导管射频消融治疗的阵发性房颤患者42例（男29例），年龄（63.1±6.5）岁，应用光感应压力监测导管在LSI指导下行双侧肺静脉电隔离术，观察导管消融贴靠压力（CF）、LSI与8个月随访成功率之间的关系。结果:①肺静脉隔离时，大部分消融位点均达到前壁LSI为5.0，后壁LSI为4.5，平均CF>10 g；②84个肺静脉隔离中，单圈隔离率为84.5%（71/84），非单圈隔离率为15.5%（13/84），整体手术即时成功率为100%；总肺静脉隔离时间为（42.5±13.7）min，左侧肺静脉隔离时间为（19.7±5.2）min，右侧肺静脉隔离时间为（22.6±6.8）min；有3例发生一过性窦性停搏；③非单圈隔离漏点与单圈隔离对应位点LSI相近（4.7±0.4对4.6±0.9， P>0.05），非单圈隔离漏点位点CF均明显低于单圈隔离对应位点[（8.9±1.6）g对（12.5±1.4）g， P<0.05]；④8个月随访观察后，总累积成功率为88.1%（37/42），单圈隔离患者累积成功率高于非单圈隔离患者[93.9%（31/33）对66.7%（6/9）， P=0.018]；⑤房颤复发患者隔离圈漏点位点平均CF为（9.6±0.8）g。 结论:LSI在房颤导管消融中对透壁性和连续性的指导安全有效，CF<10.0 g时能出现漏点，无法单圈隔离，而单圈隔离较非单圈隔离的远期效果更好。

abstractsObjective:To evaluate lesion size index (LSI) of fiberoptic contact-force sensing catheter guiding in catheter ablation of atrial fibrillation (AF) .Methods:From July 2019 to April 2020, 42 patients with paroxysmal AF (PAF) were continuous enrolled. Using TactiCath catheter under the guidance of LSI, pulmonary vein isolation (PVI) was performed. The relationship between catheter contact force (CF) , LSI and 8 month follow-up success rate were observed.Results:①In PVI, most of the ablation sites reached LSI=5.0 in anterior wall and LSI=4.5 in posterior wall, and most of the ablation sites CF>10 g.②The isolation rate of 84 pulmonary veins in 42 patients was 84.5% (71/84) . The both-side PVI circle/left-side PVI circle/right-side PVI circle isolation time were (42.5±13.7) min, (19.7±5.2) min, (22.6±6.8) min respectively.Transient sinus arrest occurred in 3 cases.③The LSI of non single circle isolation gap site and single circle isolation site were similar (4.7±0.4 vs. 4.6±0.9, P>0.05) . The CF of non single circle isolation gap site was significantly lower than that of single circle isolation site[ (8.9±1.6) g vs. (12.5±1.4) g, P<0.05].④After 8 months follow-up, the overall cumulative success rate of 42 patients was 88.1% (37/42) . The cumulative success rate of 33 single circle isolation patients was 93.9% (31/33) . The cumulative success rate of 9 non-single circle isolation patients was 66.7% (6/9) , the difference was statistically significant ( P=0.018) .⑤CF of circle isolation gap site in recurrent patients were (9.6±0.8) g. Conclusion:LSI is safe and effective in guiding the transmural and continuity of AF catheter ablation. When CF<10 g, gap may occur, which will not be isolated by single isolation, and the long-term effect may be obtained in single isolation.