Atrial electroanatomic remodeling after circumferential radiofrequency pulmonary vein ablation -: Efficacy of an anatomic approach in a large cohort of patients with atrial fibrillation
Atrial electroanatomic remodeling after circumferential radiofrequency pulmonary vein ablation -: Efficacy of an anatomic approach in a large cohort of patients with atrial fibrillation
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DOI：
10.1161/hc4601.098517
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发表时间：
2001-11-20
期刊：
影响因子：
37.8
通讯作者：
Alfieri, O
中科院分区：
文献类型：
--
作者：
Pappone, C;Oreto, G;Alfieri, O
背景-肺静脉（PV）口周围射频消融术最近被描述为心房颤动（AF）的一种新的解剖入路。方法和结果：我们连续治疗了251例阵发性（179例）或永久性（72例）房颤患者。在窦性心律（124例）或AT（127例）期间，使用三维电解剖引导将圆形PV病变经间隔放置。手术时间为148±26分钟。在单个pv （n=956）或2个具有闭合开口或共口的同侧静脉（n=24）周围的980个病变中，75%被双极电图振幅30ms定义为完整。低压圈闭面积3594 +/- 449 mm(2)，占左心房（LA）图总面积的23 +/-9%。2例（0.8%）出现严重并发症（心包填塞）。经食道超声心动图未见静脉窦狭窄。10.4 +/-4.5个月后，152例阵发性房颤患者（85%）和49例永久性房颤患者（68%）无房颤。有和没有房颤复发的患者在年龄、房颤持续时间、心脏病患病率或射血分数方面没有差异，但LA直径明显更高(P
Background- Circumferential radiofrequency ablation around pulmonary vein (PV) ostia has recently been described as a new anatomic approach for atrial fibrillation (AF).Methods and Results-We treated 251 consecutive patients with paroxysmal (n=179) or permanent (n=72) AF. Circular PV lesions were deployed transseptally during sinus rhythm (n=124) or AT (n=127) using 3D electroanatonic guidance. Procedures lasted 148 +/- 26 minutes. Among 980 lesions surrounding individual PVs (n=956) or 2 ipsilateral veins with close openings or common ostium (n=24), 75% were defined as complete by a bipolar electrogram amplitude 30 ms across the line. The amount of low-voltage encircled area was 3594 +/- 449 mm(2), which accounted for 23 +/-9% of the total left atrial (LA) map surface. Major complications (cardiac tamponade) occurred in 2 patients (0.8%). No PV stenoses were detected by transesophageal echocardiography. After 10.4 +/-4.5 months, 152 patients with paroxysmal AF (85%) and 49 with permanent AF (68%) were AF-free. Patients with and without AF recurrence did not differ in age, AF duration, prevalence of heart disease, or ejection fraction, but the LA diameter was significantly higher (P