The efficacy of inducibility and circumferential ablation with pulmonary vein isolation in patients with paroxysmal atrial fibrillation
The efficacy of inducibility and circumferential ablation with pulmonary vein isolation in patients with paroxysmal atrial fibrillation
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DOI：
10.1111/j.1540-8167.2007.00823.x
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发表时间：
2007-06-01
影响因子：
2.7
通讯作者：
Chen, Shih-Ann
中科院分区：
文献类型：
--
作者：
Chang, Shih-Lin;Tai, Ching-Tai;Chen, Shih-Ann
具有电感性的PV隔离。导言：导向性试验用于房颤（AF）导管消融的有效性的一些相互矛盾的结果已被报道。本研究的目的是探讨肺静脉隔离术（PVI）对阵发性房颤患者的诱导性和疗效及其与心房底物的关系。方法和结果：本研究包括88例阵发性房颤患者行导管消融治疗。使用NavX系统进行电解剖定位，并在窦性心律期间获得双房电压。在PVI环形消融成功后，进行诱导试验以确定是否需要建立左房（LA）消融线。术后，诱导性房颤患者的复发率高于非诱导性房颤患者（55% vs 18%, P = 0.02）。诱发性心房颤动患者在PVI后双房电压低于负诱发性心房颤动患者。诱导性房颤患者术后复发的LA电压较低（1.3 +/- 0.4 vs 1.8 +/- 0.4 mV, P = 0.02）， LA总激活时间较长（99 +/- 18 vs 88 +/- 13 msec, P = 0.02）。随访期间无左室扑动发生。结论：经PVI和非诱导性单次环周消融后，82%的患者未发生房颤复发。房颤的诱导性与房颤的复发有关，心房底物影响诱导性的结果。
PV Isolation with Inducibility. Introduction: Some conflicting results of the efficacy of the inducibility test used in the catheter ablation of atrial fibrillation (AF) have been reported. The aim of this study was to investigate the inducibility and efficacy of circumferential ablation with pulmonary vein isolation (PVI) in patients with paroxysmal AF and its relationship to the atrial substrate.Methods and Results: This study consisted of 88 patients with paroxysmal AF who underwent catheter ablation. Electroanatomic mapping using a NavX system was performed and the biatrial voltage was obtained during sinus rhythm. After successful circumferential ablation with PVI, an inducibility test was performed to determine the requirement for creating left atrial (LA) ablation line. After procedure, patients with inducible AF had a higher recurrence rate than did those with noninducibility of AF (55% vs 18%, P = 0.02). The patients with inducible AF after the PVI had a lower biatrial voltage than did those with negative inducibility. The patients with inducible AF after the final procedure who had a recurrence had a lower LA voltage (1.3 +/- 0.4 vs 1.8 +/- 0.4 mV, P = 0.02) and longer LA total activation time (99 +/- 18 vs 88 +/- 13 msec, P = 0.02) than did those with noninducible AF and no recurrence. None of the patients had occurrence of LA flutter during the follow-up.Conclusion: After a single procedure of circumferential ablation with PVI and noninducibility, 82% patients did not have recurrence of AF. The inducibility of AF was related to the recurrence of AF. The atrial substrate affected the outcome of the inducibility.