Objective To explore the radiofrequency ablation for typical atrial flutter under the guidance of non - contact mapping system. Methods Twenty - five cases of typical atrial flutter patients had been definitely diagnosed based on the body surface 12 - lead ECG and Holter, including 17 cases of paroxysmal atrial flutter and 8 of persistent atrial flutter. All patients had oral administration of 2 or more anti - arrhythmic therapeutics with poor effect. 10 - poles coronary sinus and right ventricular electrode were routinely placed, and ARRAY balloon was placed in the lower right atrium. The right atrial model was constructed, followed by ablating the tricuspid isthmus under the guidance of non - contact mapping system. Results All patients received successful ablation. Atrial flutter was terminated during the ablation in 18 cases, and 7 patients were in sinus rhythm under ablation. The delayed two -way conduction time was noted during pacing proximal coronary sinus and low right atrium respectively after surgery, no excitement was detected through the isthmus ablation line, and isthmus block was confirmed. Only one patient encountered recurrence of atrial flutter in the period of 6 to 18 months follow - up, and the recurrence rate was found to be 4.0% . Conclusion Non - contact mapping system guided radiofrequency ablation of typical atrial flutter therapy is safe and reliable, and can reduce X - ray exposure time and discharge cycles.%目的 总结非接触标测系统指导下射频消融治疗典型心房扑动的经验.方法 根据体表12导心电图及动态心电图诊断为典型心房扑动25例,其中阵发性心房扑动17例,持续性心房扑动8例.全部患者口服过2种及以上抗心律失常药物,治疗效果较差.常规放置10极冠状窦、右室电极,ARRAY球囊置于右房中下部,构建右房模型,在非接触标测系统指引下进行三尖瓣峡部消融.结果 手术全部成功,其中18例放电过程中房扑终止,7例在窦性下放电消融.术后分别起搏冠状窦近端、低位右心房,证明双向传导时间延长,同时无激动穿过峡部的消融线,证实峡部双向阻滞.术后随访6～18个月,1例复发,复发率4.0%.结论 非接触标测系统指导下射频消融治疗典型心房扑动安全可靠,同时可减少X线曝光时间及放电次数.
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