Pulmonary vein isolation with the 30 and 35 mm high-density mesh ablator
Pulmonary vein isolation with the 30 and 35 mm high-density mesh ablator
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DOI：
10.1093/europace/euq277
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发表时间：
2010-10-01
期刊：
影响因子：
6.1
通讯作者：
Stockman, Dirk
中科院分区：
文献类型：
--
作者：
De Greef, Yves;Tavernier, Rene;Stockman, Dirk
为分析30 mm和35 mm高密度网状消融器(HDMA，Bard电生理)消融阵发性房颤(房颤)的手术效果和临床效果，对64例患者进行了HDMA导管消融(其中30 mm消融26例，35 mm消融38例)。如果肺静脉(PV)分离不成功，则继续使用常规4 mm消融导管消融。成功定义为在没有抗心律失常药物的情况下，单次手术后6个月房颤自由。30 mm组有84/106(79%)个肺静脉获得肺静脉隔离，而35 mm组有149/153个(97%)肺静脉隔离(P<；0.001)。所有未隔离的静脉均用常规4 mm消融导管成功隔离。房颤6个月时，30 mm组为19%，35 mm组为18%(P=NS)。在19名患者的重复手术中，69%的PV被重新连接，与基线相比，LA-PV延迟增加了11+/-15ms。(I)与30 mm导管相比，35 mm HDMA导管被证明在获得急性肺静脉隔离方面更有效，(Ii)尽管有这些有希望的操作结果，但临床结果令人失望，(Iii)高再通率和PV电位的有限延迟表明，使用HDMA导管进行PV隔离不是永久性的。
To analyse procedural results and clinical outcome of paroxysmal atrial fibrillation (AF) ablation using the 30 and 35 mm high-density mesh ablator (HDMA, Bard Electrophysiology).Sixty-four consecutive patients were ablated with the HDMA catheter (26 with the 30 mm, 38 with the 35 mm device). If pulmonary vein (PV) isolation was unsuccessful, ablation was continued using a conventional 4 mm ablation catheter. Success was defined as freedom of AF at 6 months after a single procedure without antiarrhythmic drugs. PV isolation could be obtained in 84/106 (79%) PVs in the 30 mm group vs. 149/153 (97%) PVs in the 35 mm group (P < 0.001). All non-isolated veins were successfully isolated with the conventional 4 mm ablation catheter. Freedom of AF at 6 months was 19% in the 30 mm group vs. 18% in the 35 mm group (P = NS). During a repeat procedure in 19 patients, 69% of the PVs were reconnected with an incremental LA-PV delay of 11 +/- 15 ms compared with baseline.(i) Compared with the 30 mm, the 35 mm HDMA catheter proves to be more efficient in obtaining acute pulmonary vein isolation, (ii) despite these promising procedural results, the clinical outcome is disappointing and (iii) the high reconnection rate and the limited delay in PV potentials suggest that PV isolation with the HDMA catheter is not permanent.