Cryothermal ablation treatment of atrial flutter - Experience with a new 9 french 8 mm tip catheter
Cryothermal ablation treatment of atrial flutter - Experience with a new 9 french 8 mm tip catheter
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DOI：
10.1007/s10840-005-5840-3
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发表时间：
2005-01-01
影响因子：
1.8
通讯作者：
Affinito, V
中科院分区：
文献类型：
--
作者：
Montenero, AS;Bruno, N;Affinito, V
背景：心脏冷冻消融已被成功用于治疗多种心律失常。目的：本研究记录了我们使用一种新的9法国（FR） 8毫米冷冻导管消融治疗症状性心房扑动的经验。方法：对连续77例症状性心房扑动患者进行治疗。使用诊断导管进行电生理研究（EPS），使用9FR， 8mm尖端的四极冷冻导管（Freezor(R) MAX导管，CryoCath Technologies Inc., Kirkland, Canada）进行消融。从冠状窦（CS） os的下边缘开始，在-75°c下进行冷冻消融8分钟，形成一条通往咽鼓脊的后线。评估安全性、干预时的双向峡部阻断以及术后3个月的复发率。结果：无不良事件报告。所有患者在低温能量输送过程中均无不适。所有患者的急性干预成功率为96%，常见心房扑动患者的急性干预成功率为100%。47例患者的随访数据显示33例（70%）患者在3个月时无传导性复发。虽然有1例（2%）患者同时有症状和传导复发。在6个月的临床随访中，53例急性成功患者的数据显示，48例（91%）患者无症状，5例（9%）患者有复发记录，心电图和/或患者日记记录。结论：我们的经验表明，新型9FR， 8mm尖端四极冷冻导管在介入治疗中具有很高的成功率和良好的安全性。虽然在消融后3个月重复EPS发现30%的患者传导复发，但在6个月的临床随访中，只有9%的患者复发。需要进一步监测以评估6个月临床随访时观察到的相对低复发率是否能长期维持。
Background: Cardiac cryoablation has been used to successfully treat a variety of arrhythmias. Objective: This study documents our experience with a new 9 French (FR) 8 mm. cryocatheter for ablation treatment of symptomatic atrial flutter.Methods: A total of 77 consecutive patients with symptomatic atrial flutter were treated. Electrophysiological studies (EPS) were performed with diagnostic catheters and ablation was performed with a 9FR, 8 mm tip, quadripolar cryocatheter (Freezor(R) MAX catheter, CryoCath Technologies Inc., Kirkland, Canada). Cryoablation at -75degreesC for 8 minutes was performed, beginning at the inferior rim of the coronary sinus (CS) os and creating a posterior line to the Eustachian ridge. Safety, bidirectional isthmus block at intervention, and recurrence at 3 months post procedure were assessed.Results: There were no adverse events reported. All patients remained free of discomfort on cryoenergy delivery. The acute success rate at intervention was 96 % for all patients and 100 % for those with common atrial flutter. Follow-up data from 47 patients showed 33 (70 %) patients without conduction recurrence on repeat EPS at 3 months. Although, 1 (2 %) patient had both symptom and conduction recurrence. Data available from 53 acutely successful patients at 6 month clinical follow-up showed that 48 (91 %) patients were asymptomatic and 5 (9 %) patients had recurrence documented by ECG and/or patient diary records.Conclusions: Our experience with a new 9FR, 8 mm tip, quadripolar cryocatheter yielded a high success rate at intervention and an excellent safety profile. Although repeat EPS at 3 months post ablation identified conduction recurrence in 30 % of patients, at 6 month clinical follow-up only 9 % of patients had recurrence. Further monitoring is necessary to assess whether the relatively low recurrence rate observed at 6 month clinical follow-up is maintained over the long term.