Single-Catheter Technique for Pulmonary Vein Antrum Isolation: Is It Sufficient to Identify and Close the Residual Gaps Without a Circular Mapping Catheter?
Single-Catheter Technique for Pulmonary Vein Antrum Isolation: Is It Sufficient to Identify and Close the Residual Gaps Without a Circular Mapping Catheter?
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DOI：
10.1111/j.1540-8167.2008.01324.x
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发表时间：
2009-03-01
影响因子：
2.7
通讯作者：
Ma, Changsheng
中科院分区：
文献类型：
--
作者：
Dong, Jianzeng;Liu, Xingpeng;Ma, Changsheng
目的：本研究旨在探讨单根消融导管用于完全环肺静脉窦（PVA）隔离的可行性和有效性。背景：完全肺静脉隔离是房颤（AF）消融的主要方法。这通常是在圆形catheter.Methods的指导下进行的：110例阵发性房颤患者前瞻性随机分为两组：单导管方法（组1）和双导管方法（组2）。在进行初始周向损伤后，在组1中用单个消融导管标测和闭合残余间隙，或者在组2中用电解剖标测系统（CARTO（TM）XP，Biosense-Webster Inc.，钻石吧，CA，USA）。结果：初次消融后，110例患者中有22例实现了双侧PVA完全隔离。使用单根消融导管通过激活标测可以正确识别所有剩余间隙。这些剩余间隙的分布是不对称的。在第1组中，沿右侧PVA病变识别出25个间隙沿着，沿左侧PVA病变识别出49个间隙沿着。所有残余间隙均采用单导管法闭合。在第2组中，使用环形导管识别右侧28个间隙和左侧53个间隙，并通过进一步消融闭合。两组之间的手术数据和临床结局是comparable.Conclusions：单消融导管技术是可行的，有效的环形导管标测定位残余间隙PVA隔离阵发性AF消融过程中。（《心血管电生理学杂志》，第20卷，第20页。273-279，2009年3月）。
Single Catheter for Pulmonary Vein Isolation.Objectives: The present study was designed to investigate the feasibility and efficacy of single ablation catheter for complete circumferential pulmonary vein antrum (PVA) isolation.Background: Complete isolation of pulmonary veins is the mainstay for atrial fibrillation (AF) ablation. This is usually performed under the guidance of a circular catheter.Methods: One hundred and ten consecutive patients with paroxysmal AF were prospectively randomized into two groups: single-catheter approach (group 1) and double-catheter approach (group 2). After performing initial circumferential lesions, residual gaps were mapped and closed with single ablation catheter in group 1 or guided by a circular mapping catheter in group 2 using an electroanatomic mapping system (CARTO (TM) XP, Biosense-Webster Inc., Diamond Bar, CA, USA).Results: Complete bilateral PVA isolation was achieved in 22 of the 110 patients after initial ablation. All residual gaps could be correctly identified by activation mapping using single ablation catheter. The distribution of these residual gaps was asymmetric. In group 1, 25 gaps along the right PVA lesions and 49 gaps along the left PVA lesions were identified. All the residual gaps were closed with single-catheter approach. In group 2, 28 gaps on the right side and 53 gaps on the left side were identified using a circular catheter and closed with further ablations. The procedure data and clinical outcomes between the two groups were comparable.Conclusions: Single ablation catheter technique is feasible and as effective as circular catheter mapping in localizing the residual gaps for PVA isolation during ablation of paroxysmal AF.(J Cardiovasc Electrophysiol, Vol. 20, pp. 273-279, March 2009).