Efficacy of Additional Ablation of Complex Fractionated Atrial Electrograms for Catheter Ablation of Nonparoxysmal Atrial Fibrillation
Efficacy of Additional Ablation of Complex Fractionated Atrial Electrograms for Catheter Ablation of Nonparoxysmal Atrial Fibrillation
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DOI：
10.1111/j.1540-8167.2008.01393.x
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发表时间：
2009-06-01
影响因子：
2.7
通讯作者：
Chen, Shin-Ann
中科院分区：
文献类型：
--
作者：
Lin, Yenn-Jiang;Tai, Ching-Tai;Chen, Shin-Ann
非阵发性心房颤动的导管消融：背景：在非阵发性心房颤动（AF）患者的单次消融术中，复杂碎裂心房电图（CFE）消融的有效性尚未得到很好的证明。本研究的目的是比较肺静脉电隔离（PVI）加线性消融伴或不伴CFEs额外消融的消融策略在这些patients.Methods：对比60例非阵发性房颤患者（49 +/- 11岁，男性50例，女性10例）接受NavX标测系统引导下的导管消融。一个逐步的方法包括一个环形PVI和左心房（LA）的线性消融，然后在LA/冠状窦（前30例）或不（第二30例）的连续CFE的额外消融，检测到的自动algorithm.Results：有两组之间的基线特征没有差异。完全PVI消除了一些连续的CFE，并改变了CFE的分布。肺静脉隔离和线性消融后，在左心房和冠状窦的7.9 +/- 10%标测部位发现了剩余的连续CFE，并成功消融，手术房颤终止率为53%。随访19 +/- 11个月，Kaplan-Meier分析显示，额外消融CFE的患者窦性心律维持率较高。多因素分析显示，单次消融成功率可通过房颤终止率和对左房/冠状窦连续性CFE的额外消融来预测。结论：基于单次消融术的结果，肺静脉隔离和左房线性消融后连续性CFE的消融具有更好的长期疗效。（J.E. Vasc Electrophysiol，第20卷，第100页）。607-615，2009年6月）。
Catheter Ablation of Nonparoxysmal Atrial Fibrillation.Background: The efficacy of ablation of complex fractionated atrial electrograms (CFEs) in the single ablation procedure for nonparoxysmal atrial fibrillation (AF) patients is not well demonstrated. The aim of this study was to compare the ablation strategies of pulmonary vein isolation (PVI) plus linear ablation with and without additional ablation of CFEs in these patients.Methods: Consecutive 60 patients (49 +/- 11 years old, 50 male, 10 female) with nonparoxysmal AF underwent catheter ablation guided by a NavX mapping system. A stepwise approach included a circumferential PVI and left atrial (LA) linear ablation followed by either the additional ablation of continuous CFEs in the LA/coronary sinus (the first 30 patients) or not (the second 30 patients), detected by an automatic algorithm.Results: There was no difference in the baseline characteristics between the two groups. Complete PVI eliminated some continuous CFEs and altered the distribution of CFEs. Following PVI and linear ablation, the remaining continuous CFEs were identified in 7.9 +/- 10% mapping sites of the LA and CS, and were ablated successfully with a procedural AF termination rate of 53%. With a follow-up of 19 +/- 11 months, a Kaplan-Meier analysis showed that the patients with additional ablation of the CFEs had a higher rate of sinus rhythm maintenance. Multivariate analysis showed the single procedure success could be predicted by the procedural AF termination and the additional ablation of continuous CFEs in the LA/CS.Conclusions: Ablation of continuous CFEs after PVI and LA linear ablation had a better long-term efficacy based on the results of single-ablation procedure.(J Cardiovasc Electrophysiol, Vol. 20, pp. 607-615, June 2009).