Balloon catheter ablation to treat paroxysmal atrial fibrillation: What is the level of pulmonary venous isolation?
Balloon catheter ablation to treat paroxysmal atrial fibrillation: What is the level of pulmonary venous isolation?
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DOI：
10.1016/j.hrthm.2007.11.006
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发表时间：
2008-03-01
期刊：
影响因子：
5.5
通讯作者：
Ruskin, Jeremy N.
中科院分区：
文献类型：
--
作者：
Reddy, Vivek Y.;Neuzi, Petr;Ruskin, Jeremy N.
背景与最初设计用于在肺静脉（PV）内输送消融病变的球囊消融导管不同，当前的球囊原型被设计用于在PV口输送病变。方法：在总共14例阵发性房颤患者中，使用冷冻球囊导管进行肺静脉隔离，激光导管（4例患者）或超声球囊导管（2例患者）。患者接受术前计算机断层扫描/磁共振成像。使用心内超声导管辅助将球囊导管定位在肺静脉口/窦部。在所有患者中，窦性心律双极电压振幅图（使用CARTO与计算机断层扫描/磁共振图像集成或NavX标测）在基线和使用环形标测导管确认的肺静脉电隔离后生成。电解剖标测显示，使用3种球囊导管中的任何一种进行消融后，隔离范围包括每个肺静脉的管状部分至肺静脉口水平。然而，肺静脉窦部分左喉未消融与所有3球囊technology.CONCLUSION使用当前一代的球囊消融导管，电隔离发生在肺静脉口的水平，但胃窦区域是喉未消融。
BACKGROUND Unlike the initial balloon ablation catheters that were designed to deliver ablation Lesions within the pulmonary veins (PVs), the current balloon prototypes are fashioned to deliver lesions at the PV ostia.OBJECTIVE Using etectroanatomical mapping, this study evaluates the actual location of ablation Lesions generated by cryobased, laser-based, or uttrasound-based balloon catheters.METHODS In a total of 14 patients with paroxysmal atrial fibrillation, PV isolation was performed using either a cryoballoon catheter (8 patients), Laser catheter (4 patients) or ultrasound balloon catheter (2 patients). Patients underwent preprocedural computed tomographic/magnetic resonance imaging. An intracardiac ultrasound catheter was used to aid in positioning the balloon catheter at the PV ostium/antrum. In all patients, sinus rhythm bipolar voltage amplitude maps (using either CARTO with computed tomographic/magnetic resonance image integration or NavX mapping) were generated at baseline and after electrical PV isolation as confirmed by use of a circular mapping catheter.RESULTS Eectrical isolation was achieved in 100% of the PVs. Electroanatomical mapping revealed that after ablation with any of the 3 balloon catheters, the extent of isolation included the tubular portions of each PV to the Level of the PV ostia. However, the PV antral portions were Left Largely unablated with all 3 balloon technologies.CONCLUSION Using the current generation of balloon ablation catheters, electrical isolation occurs at the level of the PV ostia, but the antral regions are Largely unablated.