Ablation of atrial fibrillation in the rapid pacing canine model using a multi-electrode loop catheter.
Ablation of atrial fibrillation in the rapid pacing canine model using a multi-electrode loop catheter.
复制标题
使用多电极环导管消融快速起搏犬模型中的心房颤动。
DOI：
10.1016/s0735-1097(01)01208-6
复制
发表时间：
2001
影响因子：
24
通讯作者：
Helms,R
中科院分区：
文献类型：
--
作者：
Avitall,B;Urbonas,A;Millard,S;Urboniene,D;Helms,R
目的：本研究详细介绍了我们使用环形导管消融犬心房颤动（AF）的经验。背景：房颤是最常见的心律失常，发病率高。窦性心律转换后维持正常的窦性心律（NSR）对许多患者来说仍然是一个挑战。方法在29只犬快速心房起搏模型中，采用多电极环形导管制造线性心房病变，消融房颤。在六个月的恢复期评估心律状态，之后进行组织分析。结果90%的病例可迅速转化为心性心动过速或心性心动过速。26例转换中有6例仅在左心房病变后发生，2例仅在右心房病变后发生。导致房颤转换的26个病变中有16个（62%）发生在左心室，这16个转换中有11个发生在连接二尖瓣环和肺静脉的病变中。环形电极和线圈电极的急性转换率相似，但线圈电极的AT发生率更高（63%对31%）。6个月时，80%的狗处于NSR状态，14%的狗处于At状态，7%的狗仍处于AF状态。通电后，p波振幅平均下降64±26%。组织分析显示，当最终结果为NSR时，病变呈跨壁连续性；当房颤持续存在时，病变呈非跨壁/非连续性。结论在该犬模型中，多电极环形导管可在双心房形成连续的跨壁病变，从而安全有效地消融房颤，并提供稳定的长期节律结果。左心房似乎是维持房颤的主要腔室。心房心动过速是线圈电极常见的急性结果。
OBJECTIVESThis investigation details our experience using a loop catheter to ablate atrial fibrillation (AF) in dogs.BACKGROUNDAtrial fibrillation is the most common arrhythmia and has significant morbidity. Maintenance of normal sinus rhythm (NSR) after conversion in many patients is still a challenge.METHODSA multi-electrode loop catheter was used to create linear atrial lesions to ablate AF in a rapid atrial pacing model in 29 dogs. Rhythm status was assessed over a six-month recovery period, after which tissue analysis was performed.RESULTSAcute conversion to NSR or atrial tachycardia (AT) was achieved in 90% of cases. Six of 26 conversions occurred after only left atrial (LA) lesions, and two after just right atrial lesions. Sixteen (62%) of 26 lesions that resulted in AF conversion were in the LA, and 11 of these 16 conversions occurred during a lesion connecting the mitral ring to the pulmonary veins. Acute conversion rate was similar with ring and coil electrodes, but AT was more frequent with coil electrodes (63% vs. 31%). At six months 80% of dogs were in NSR, 14% were in AT, and 7% remained in AF. There was an average reduction in P-wave amplitude of 64 ± 26% after power application. Tissue analysis revealed transmural contiguous lesions when final outcome was NSR, and nontransmural/noncontiguous lesions where AF persisted.CONCLUSIONSMulti-electrode loop catheters can create contiguous transmural lesions in either atrium to safely and effectively ablate AF and provide a stable long-term rhythm outcome in this dog model. The left atrium appears to be the dominant chamber that sustains AF. Atrial tachycardia is a frequent acute outcome with coil electrodes.
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