Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction - Final results of a prospective, multicenter clinical trial
Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction - Final results of a prospective, multicenter clinical trial
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DOI：
10.1161/01.cir.99.2.262
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发表时间：
1999-01-19
期刊：
影响因子：
37.8
通讯作者：
Prystowsky, E
中科院分区：
文献类型：
--
作者：
Calkins, H;Yong, P;Prystowsky, E
背景-本研究的目的是评估温控射频导管消融系统的安全性和有效性。方法和结果-患者群体包括1050名接受过房室结折返性心动过速(AVNRT)、旁道(AP)或房室交界处(AVJ)消融的患者。996例患者消融成功。房室结消融患者的成功率最高，房室结消融患者的成功率最低，而房室结消融患者的成功率介于两者之间。32例患者发生严重并发症。有四个变量预测消融成功(AVJ、AVNRT或左游离壁AP消融和有经验的中心)。有四个因素预测心律失常复发(右游离壁、后间隔、间隔和多发房间隔)。两个变量预测并发症的发生(结构性心脏病和多个靶点的存在)，三个变量预测死亡风险的增加(心脏病、较低的射血分数和房室结消融)。结论--这些发现可以指导临床医生考虑适合消融的患者的治疗方案。
Background-The purpose of this study was to evaluate the safety and efficacy of a temperature-controlled radiofrequency catheter ablation system.Methods and Results-The patient population included 1050 patients who had undergone ablation of atrioventricular nodal reentrant tachycardia (AVNRT), an accessory pathway (AP), or the atrioventricular junction (AVJ). Ablation was successful in 996 patients. The probability of success was highest among patients who had undergone ablation of the AVJ, lowest in patients who had undergone ablation of an AP, and in between for patients who had undergone ablation of AVNRT. A major complication occurred in 32 patients. Four variables predicted ablation success (AVJ, AVNRT, or left free wall AP ablation and an experienced center). Four factors predicted arrhythmia recurrence (right free wall, posteroseptal, septal, and multiple APs). Two variables predicted development of a complication (structural heart disease and the presence of multiple targets), and 3 variables predicted an increased risk of death (heart disease, lower ejection fraction, and AVJ ablation).Conclusions-These findings may serve as a guide to clinicians considering therapeutic options in patients who are candidates for ablation.