Magnetic versus manual catheter navigation for mapping and ablation of right ventricular outflow tract ventricular arrhythmias: A randomized controlled study
Magnetic versus manual catheter navigation for mapping and ablation of right ventricular outflow tract ventricular arrhythmias: A randomized controlled study
复制标题
磁力导管导航与手动导管导航对右心室流出道室性心律失常的标测和消融：一项随机对照研究
DOI：
10.1016/j.hrthm.2013.05.012
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发表时间：
2013-08-01
期刊：
影响因子：
5.5
通讯作者：
Chen, Minglong
中科院分区：
文献类型：
--
作者：
Zhang, Fengxiang;Yang, Bing;Chen, Minglong
背景：没有随机对照研究前瞻性比较了远程磁控（RMC）与手动导管控制（MCC）在右心室流出道（RVOT）室性早搏（VPC）或室性心动过速（VT）消融期间的性能和临床结局。。目的本研究的目的是前瞻性评价使用RMC与MCC进行RVOT标测和消融的有效性和安全性方法30例特发性右室流出道室性早搏/室性心动过速患者随机分为RMC组和MCC组。在RVOT中部署非接触式标测系统以识别VPC/VT的起源。进行常规激动和起搏标测以引导消融。如果使用1种导管控制模式进行的消融完全不成功，则患者将转入另一组。主要终点是患者和医生的透视曝光和times.Results平均手术时间之间的RMC和MCC组相似。RMC组患者和医生的透视暴露和时间远低于MCC组。MCC组15例患者中有14例消融成功，RMC组15例患者中有10例消融成功。交叉后，所有患者均获得即刻成功。两组均未发生严重并发症。在22个月的随访中，RVOT VPC复发2 RMCpatient.CONCLUSION RMC导航显着减少患者和医生的透视时间分别为50.50/0和68.6%，当与非接触式标测系统结合使用，以指导消融RVOT VPC/VT。
BACKGROUND No randomized controlled study has prospectively compared the performance and clinical outcomes of remote magnetic control (RMC) vs manual catheter control (MCC) during ablation of right ventricular outflow tract (RVOT) ventricular premature complexes (VPC) or ventricular tachycardia (VT).OBJECTIVE The purpose of this study was to prospectively evaluate the efficacy and safety of using either RMC vs MCC for mapping and ablation of RVOT VPC/VT.METHODS Thirty consecutive patients with idiopathic RVOT VPC/VT were referred for catheter ablation and randomized into either the RMC or MCC group. A noncontact mapping system was deployed in the RVOT to identify origins of VPC/VT. Conventional activation and pace-mapping was performed to guide ablation. If ablation performed using 1 mode of catheter control was acutely unsuccessful, the patient crossed over to the other group. The primary endpoints were patients' and physicians' fluoroscopic exposure and times.RESULTS Mean procedural times were similar between RMC and MCC groups. The fluoroscopic exposure and times for both patients and physicians were much lower in the RMC group than in the MCC group. Ablation was acutely successful in 14 of 15 patients in the MCC group and 10 of 15 in the RMC group. Following crossover, acute success was achieved in all patients. No major complications occurred in either group. During 22 months of follow-up, RVOT VPC recurred in 2 RMC patients.CONCLUSION RMC navigation significantly reduces patients' and physicians' fluoroscopic times by 50.50/0 and 68.6%, respectively, when used in conjunction with a noncontact mapping system to guide ablation of RVOT VPC/VT.