Additional left atrial septal line does not improve outcome of patients undergoing ablation for long-standing persistent atrial fibrillation
Additional left atrial septal line does not improve outcome of patients undergoing ablation for long-standing persistent atrial fibrillation
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DOI：
10.2143/ac.65.2.2047048
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发表时间：
2010-04-01
影响因子：
1.6
通讯作者：
Lebedev, Dmitry
中科院分区：
文献类型：
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作者：
Mikhaylov, Evgeny;Gureev, Sergey;Lebedev, Dmitry
目的 - 对接受长期持续性心房颤动 (AF) 消融的患者进行额外的室间隔线性消融可能是有益的，因为额外的广泛心房组织消融和复杂分割电图部位的偶然消融。我们评估了使用额外的左心房 (LA) 间隔线消融长期持续性 AF 后患者的长期结果。方法 - 纳入了 34 名患者。患者被随机分为两组，并接受肺静脉（PV）隔离、屋顶线、二尖瓣峡部线和冠状窦消融。在第 I 组中，创建了额外的 LA 间隔线。结果 - 在第 I 组中，2 名患者在间隔消融过程中房颤转变为房性心动过速。在第 2 组中，3 名患者通过房性心动过速终止房颤 (P = ns)。在平均 620 +/- 119 天的随访期间，第 I 组和第 2 组中有 7 名 (41%) 和 8 名 (47%) 患者未出现复发 (P = ns)。第 I 组的 5 名患者和第 2 组的 5 名患者进行了重做手术。在最后一次消融后 349 +/- 273 天的随访中，Cox 的 F 检验显示第 1 组有更多复发的趋势 (P = 0.07)。结论 - 在长期 AF 患者中，额外的 LA 间隔线性消融与显着较高的 AF 终止率无关。间隔线性病变可能会增加间隔折返性心动过速的风险，并且与更差结果的趋势相关。
Objective - Additional septal linear ablation in patients undergoing ablation of long-standing persistent atrial fibrillation (AF) could be beneficial due to additional extensive atrial tissue ablation and incidental ablation of sites with complex fractionated electrograms. We assessed the long-term outcome of patients after ablation of long-standing persistent AF with an additional left atrial (LA) septal line.Methods - Thirty-four patients were included. The patients were randomized into two groups and underwent pulmonary vein (PV) isolation with roof line, mitral isthmus line and coronary sinus ablation. In group I an additional LA septal line was created.Results - AF converted into atrial tachycardia in 2 patients during septal ablation in group I. In group 2 AF terminated via atrial tachycardia in 3 patients (P = ns). During a mean follow-up of 620 +/- 119 days, 7 (41%) and 8 (47%) patients from group I and group 2 were free from recurrences (P = ns). Redo procedures were performed in 5 patients of group I and in 5 patients of group 2. For a follow-up of 349 +/- 273 days after the last ablation, Cox's F-test showed a trend of more recurrences in group 1 (P = 0.07).Conclusions - In patients with long-standing AF, an additional LA septal linear ablation is not associated with a significantly higher AF termination rate. A septal linear lesion might increase the risk of septal reentrant tachycardias, and is associated with a trend towards a worse outcome.