The impact of CT image integration into an electroanatomic mapping system on clinical outcomes of catheter ablation of atrial fibrillation
The impact of CT image integration into an electroanatomic mapping system on clinical outcomes of catheter ablation of atrial fibrillation
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DOI：
10.1111/j.1540-8167.2006.00594.x
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发表时间：
2006-10-01
影响因子：
2.7
通讯作者：
Schilling, Richard J.
中科院分区：
文献类型：
--
作者：
Kistler, Peter M.;Rajappan, Kim;Schilling, Richard J.
背景资料：左心房/肺静脉（LA/PV）解剖结构的详细评价可能对提高房颤（AF）导管消融（CA）的安全性和成功率非常重要。目的：本非随机研究的目的是确定将计算机断层扫描（CT）图像整合到三维（3D）标测系统中对接受CA治疗AF患者的临床结局的影响。方法：94例房颤患者（年龄：56 ± 10岁）（阵发性46例，持续性48例）接受了使用灌注射频消融（终点为电隔离）对同侧肺静脉对的广泛环绕治疗。47例（3DM组）患者仅通过3D标测（电解剖24例，非接触式23例）引导消融，47例（CT组）患者通过CT图像集成（Cartomerase（R））引导消融。在持续性AF，线性消融和复杂的碎裂electrograms的靶向消融相结合performed.Results：成功的PV电隔离两组之间没有差异。CT组的透视时间显著减少（49 +/- 27分钟vs 3DM组62 +/- 26分钟，P = 0.03）。CT组心律失常复发率为32%，明显低于3DM组的51%（P < 0.01）。对30例有症状的患者（CT组12例，3DM组18例），再次手术治疗AF（3DM组13例，CT组5例，P
Background: A detailed appreciation of left atrial/pulmonary vein (LA/PV) anatomy may be important in improving the safety and success of catheter ablation (CA) for atrial fibrillation (AF).Objectives: The aim of this nonrandomized study was to determine the impact of computerized tomography (CT) image integration into a 3-dimensional (3D) mapping system on the clinical outcome of patients undergoing CA for AF.Methods: Ninety-four patients (age: 56 +/- 10 years) with AF (paroxysmal 46, persistent 48) underwent wide encirclement of ipsilateral PV pairs using irrigated radiofrequency ablation with the endpoint of electrical isolation. Ablation was guided by 3D mapping alone (electroanatomic 24, noncontact 23) in 47 (3DM group) patients and by CT image integration (Cartomerge (R)) in 47 (CT group). In persistent AF, a combination of linear ablation and targeted ablation of complex fractionated electrograms was also performed.Results: Successful PV electrical isolation did not differ between the two groups. A significant reduction in fluoroscopy times was demonstrated in the CT group (49 +/- 27 minutes vs 3DM group 62 +/- 26 minutes, P = 0.03). Arrhythmia recurrence was reduced in the CT group (32% vs 51% in the 3DM group, P < 0.01). In 30 symptomatic patients (12 CT and 18 3DM), repeat procedures for AF (13 in 3DM and 5 CT, P