Relationship between lesion formation and electrophysiological responses using catheters equipped with mini-electrodes in chronic atrial fibrillation.
Relationship between lesion formation and electrophysiological responses using catheters equipped with mini-electrodes in chronic atrial fibrillation.
复制标题
使用配备微型电极的导管在慢性心房颤动中病变形成与电生理反应之间的关系。
DOI：
10.1016/j.hrthm.2017.01.041
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发表时间：
2017
期刊：
影响因子：
5.5
通讯作者：
Joseph Koblish
中科院分区：
文献类型：
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作者：
B. Avitall;Arthur Kalinski;Piotr Horbal;Joseph Koblish
本研究重点研究了在心房颤动(房颤)模型中，使用4.5 mm灌流导管和8 mm标准导管，在末端周向放置微型电极(MES)的情况下，与病变形成相关的电生理变化。目的探讨心房颤动(房颤)模型中最大电信号(EGM)减少、频谱漂移及其对心房病变形成的影响。此外，我们假设MES的高保真记录可以改善对消融组织和非消融组织的区分。方法在透视和NavX引导下，对4只慢性房颤犬(房颤12个月)放置心房消融灶，以实现腔内、腔三尖瓣峡部和左房毗邻病变。损伤时间被滴定到MES记录的最大EGM幅度损失。结果在使用4.5 mm导管形成的病灶(172个病灶)和使用8 mm导管形成的病灶(155个病灶)中，EGM下降到最低点的时间分别为22±12秒和22±9秒(NS：P>；0.05)。结论在慢性房颤模型中，MES记录的EGM减幅和频谱漂移是4.5 mm和8 mm尖环电极记录的减幅的两倍。基于最大EGM减少量的射频滴定是监测病变形成的有效方法，并可通过防止不必要的延长射频应用来提高安全性。ME EGM记录极大地方便了邻近的跨壁线状病变的放置。
BackgroundThe study focuses on the electrophysiological changes associated with lesion formation using 4.5-mm irrigated and 8-mm standard catheters equipped with mini-electrodes (MEs) positioned circumferentially on the tip.ObjectiveThe aim of the study was to test the relationship between the maximal electrogram (EGM) reduction, frequency spectrum shift, and their impact on atrial lesion formation in the atrial fibrillation (AF) model. Furthermore, we hypothesize that the high fidelity recording from the MEs allows improved discrimination of ablated tissues from nonablated tissues.MethodsUnder fluoroscopic and NavX guidance, atrial ablation lesions were placed in 4 canines in chronic AF (>12 months in AF) to achieve intercaval, cavotricuspid isthmus, and left atrial contiguous lesions. Lesion times were titrated to the maximal loss of EGM amplitude as recorded from the MEs. Radiofrequency (RF) lesions were sequentially connected on the basis of the ME recordings of tissue viability.ResultsIn lesions formed using a 4.5-mm irrigated catheter (172 lesions) and in those formed using an 8-mm catheter (155 lesions), the time to nadir of the EGM reduction was 22 ± 12 and 22 ± 9 seconds (NS:p>0.05). Contiguous transmural lesions were successfully placed and guided by the ME EGMs and confirmed by frequency spectra.ConclusionIn the chronic AF model, EGM reduction and frequency spectrum shift recorded from the MEs are twice the reduction recorded using the 4.5mm and 8mm tip to ring electrodes. RF titration based on the maximal EGM diminution is an effective approach to monitor lesion formation and may improve safety by preventing unnecessarily prolonged RF application. The ME EGM recording greatly facilitates placement of contiguous transmural linear lesions.
影响因子：
--
作者：
P. Wolf;R. Abbott;W. Kannel
通讯作者：
P. Wolf;R. Abbott;W. Kannel
使用多电极环导管消融快速起搏犬模型中的心房颤动。
影响因子：
24
作者：
Avitall,B;Urbonas,A;Millard,S;Urboniene,D;Helms,R
通讯作者：
Helms,R