Ablation of Persistent Atrial Fibrillation Using Multielectrode Catheters and Duty-Cycled Radiofrequency Energy
Ablation of Persistent Atrial Fibrillation Using Multielectrode Catheters and Duty-Cycled Radiofrequency Energy
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DOI：
10.1016/j.jacc.2009.07.009
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发表时间：
2009-10-06
影响因子：
24
通讯作者：
Morady, Fred
中科院分区：
文献类型：
--
作者：
Scharf, Christoph;Boersma, Lucas;Morady, Fred
目的本研究的目的是评估一种新型的，多电极，占空比循环射频消融（RFA）系统的有效性和安全性，长期持续性房颤（AF）。背景RFA持续性AF仍然是一个漫长的和具有挑战性的procedure.Methods在5个欧洲中心，50例长期持续性AF接受RFA。使用环形肺静脉（PV）消融导管进行PV隔离。复杂碎裂心房电图的目标是在房间隔使用多阵列间隔消融导管和左心房使用多阵列ablation catheters.Results在平均总手术时间为155 +/- 40 min，完全PV隔离和复杂碎裂心房电图消融在所有患者中实现。在50%的患者中，使用相同的策略和技术进行了再次消融。未发生器械相关不良事件。6个月时，7天霍尔特心电图显示50例患者中有40例（80%）AF减少> 80%，50例患者中有32例（64%）停用抗心律失常药物。在最后一次手术后20 +/- 4个月，47例患者中有31例（66%）的AF负担减少> 80%，21例患者（45%）没有AF和停用抗心律失常药物。结论这项最初的50例患者多中心研究表明，短期成功率为80%，20个月时为66%，在持续性房颤患者中，使用3根解剖结构特异性多电极消融导管和低能量占空比射频能量，并发症发生率较低，手术时间相对较短。（J Am科尔心脏病学杂志2009;54：1450-6）（C）2009年美国心脏病学会基金会
Objectives The purpose of this study was to assess the efficacy and safety of a novel, multielectrode, duty-cycled radiofrequency ablation (RFA) system for long-standing persistent atrial fibrillation (AF).Background RFA for persistent AF remains a lengthy and challenging procedure.Methods In 5 European centers, 50 patients with long-standing persistent AF underwent RFA. A circular pulmonary vein (PV) ablation catheter was used for PV isolation. Complex fractionated atrial electrograms were targeted at the interatrial septum using a multiarray septal ablation catheter and in the left atrium using a multiarray ablation catheter.Results During a mean total procedure time of 155 +/- 40 min, complete PV isolation and complex fractionated atrial electrogram ablation were achieved in all patients. In 50% of patients, redo ablation was performed using the same strategy and technology. There were no device-related adverse events. At 6 months, a 7-day Holter electrocardiogram showed > 80% AF reduction in 40 of 50 patients (80%), and 32 of 50 (64%) were off antiarrhythmic drugs. At 20 +/- 4 months after the last procedure, 31 of 47 patients (66%) had a > 80% reduction in AF burden, with 21 patients (45%) free of AF and off antiarrhythmic drugs.Conclusions This initial 50-patient multicenter study demonstrates a 80% short-term and 66% success rate at 20 months, with a low complication rate and a relatively short procedure time in patients with persistent AF using 3 anatomically specific multielectrode ablation catheters and low-energy duty-cycled radiofrequency energy. (J Am Coll Cardiol 2009;54:1450-6) (C) 2009 by the American College of Cardiology Foundation