Randomized comparison between open irrigation technology and intracardiac-echo-guided energy delivery for pulmonary vein antrum isolation: Procedural parameters, outcomes, and the effect on esophageal injury
Randomized comparison between open irrigation technology and intracardiac-echo-guided energy delivery for pulmonary vein antrum isolation: Procedural parameters, outcomes, and the effect on esophageal injury
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DOI：
10.1111/j.1540-8167.2007.00879.x
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发表时间：
2007-06-01
影响因子：
2.7
通讯作者：
Brachmann, Johannes
中科院分区：
文献类型：
--
作者：
Marrouche, Nassir F.;Guenther, Jens;Brachmann, Johannes
肺静脉窦隔离。介绍：我们进行了一项前瞻性研究，以比较开放式灌注头（OIT）技术与心内超声（ICE）引导能量输送在PVAI患者中的有效性和安全性。方法和结果：53名PVAI患者随机接受OIT导管消融术第1组26例;温度和功率分别设置为50度和50 W，盐水泵流速为30 mL/min）或在ICE引导下进行射频（RF）能量输送（第2组，27名患者;根据微泡形成滴定能量）。第1组的平均手术时间和透视暴露较低（分别为164 +/- 42 min和7，560 +/-2，298 mu Graym（2）vs 204 +/- 47 min和12，240 +/-4，356 mu Graym（2）; P = 0.005和0.008）。此外，与第2组相比，第1组每个肺静脉窦施加的射频损伤持续时间较短（分别为5.1 ± 2.2 min vs 9.2 ± 3.2 min，P = 0.03）。在PVAI后24小时内，第1组35.7%（所有红斑）和第2组57.1%（21.4%红斑和35.7%坏死）的患者记录了食管壁变化。14 +/- 2个月的随访后，复发记录在19.2%的第1组和22.2%的第2组patients.Conclusion：虽然OIT和ICE引导的能量输送具有类似的效果，在治疗AF，OIT似乎是上级方面实现隔离和缩短透视曝光。此外，观察到使用OIT治疗PVAI的食管壁损伤发生率较低。
Pulmonary Vein Antrum Isolation. Introduction: We performed a prospective study to compare efficacy and safety of both open irrigation tip (OIT) technology with intracardiac echo (ICE)-guided energy delivery in patients presenting for PVAI.Methods and Results: Fifty-three patients presenting for PVAI were randomized to ablation using an OIT catheter (Group 1, 26 patients; temperature and power were set at 50 degrees and 50 W, respectively, with a saline pump flow rate of 30 mL/min) or radiofrequency (RF) energy delivery under ICE guidance (Group 2, 27 patients; energy was titrated based on microbubbles formation). The mean procedure time and fluoroscopy exposure were lower in Group 1 (164 +/- 42 min and 7,560 +/- 2,298 mu Graym(2) vs 204 +/- 47 min and 12,240 +/- 4,356 mu Graym(2); P = 0.005 and 0.008, respectively). Moreover, the durations of RF lesions applied per PV antrum was lower in Group 1 compared with Group 2 (5.1 +/- 2.2 min vs 9.2 +/- 3.2 min, P = 0.03, respectively). Within 24 hours after PVAI in 35.7% (all erythema) of Group 1 and 57.1% (21.4% erythema and 35.7% necrosis) of Group 2, patients' esophageal wall changes were documented. After 14 +/- 2 months of follow up, recurrences were documented in 19.2% of Group 1 and 22.2% of Group 2 patients.Conclusion: Although both OIT and ICE-guided energy delivery possess a similar effect in treating AF, OIT seems to be superior in terms of achieving isolation and shortening fluoroscopy exposure. Moreover, a lower incidence of esophageal wall injury was observed utilizing OIT for PVAI.