The impact of the procedural parameters on the lesion characteristics associated with AF recurrence: Late‐gadolinium enhancement magnetic resonance imaging (LGE‐MRI) analysis
The impact of the procedural parameters on the lesion characteristics associated with AF recurrence: Late‐gadolinium enhancement magnetic resonance imaging (LGE‐MRI) analysis
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程序参数对 AF 复发相关病变特征的影响：晚期钆增强磁共振成像 (LGE-MRI) 分析
DOI：
10.1111/jce.15805
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发表时间：
2023
影响因子：
2.7
通讯作者：
Negi Noriyuk
中科院分区：
文献类型：
--
作者：
Takahara Hiroyuki;Kiuchi Kunihiko;Fukuzawa Koji;Takami Mitsuru;Izawa Yu;Nakamura Toshihiro;Nakasone Kazutaka;Sonoda Yusuke;Yamamoto Kyoko;Suzuki Yuya;Tani Ken‐ichi;Iwai Hidehiro;Nakanishi Yusuke;Shoda Mitsuhiko;Murakami Atsushi;Yonehara Shogo;Negi Noriyuk
背景通过晚期Gd增强磁共振成像(LGE-MRI)评估的消融间隙与肺静脉隔离术后房颤(AF)复发有关。动物研究表明，导管接触力(CF)、稳定性和方向性与病变的形成密切相关。然而，这些操作因素对与房颤复发相关的病变特征的影响还没有得到很好的讨论。在食道温度监测下，用35 W、30 S进行射频治疗。病灶间距为4 mm。术后3个月行LGE-MRI检查，根据LGE体积(Ml)、间隙数(GN)和平均间隙长度(AGL[mm])进行评估。间隙定义为~gt；4 mm的非强化部位。结果30例患者中6例(20%)术后12个月房颤复发。单因素分析显示AGL与房颤复发有关(危险比[HR]：1.2 0，可信区间[CI]：1.03-1.42，p= .02)。所有房颤复发均发生在平均年龄为>；7 mm的患者。导管-CF和稳定性与>；7 mm的平均直径相关，而与方位无关(CF-HR：0.62，CI：0.39-0.97，p= .038；稳定性-HR：0.8，CI：0.66-0.98，p= .027)。结论低CF和导管稳定性差的射频消融术有潜在的风险，可能会产生与房颤复发相关的大的病变间隙。
BackgroundLesion gaps assessed by late‐gadolinium enhancement magnetic resonance imaging (LGE‐MRI) are associated with the atrial fibrillation (AF) recurrence after pulmonary vein isolation. Animal studies have demonstrated that the catheter‐contact force (CF), stability, and orientation are strongly associated with lesion formation. However, the impact of those procedural factors on the lesion characteristics associated with AF recurrence has not been well discussed.MethodsA total of 30 patients with paroxysmal AF who underwent catheter ablation were retrospectively enrolled. Radiofrequency (RF) applications were performed with 35 W for 30 s in a point‐by‐point fashion under esophageal temperature monitoring. The inter‐lesion distance was 4 mm. The lesions were visualized by LGE‐MRI 3 months postprocedure and assessed by the LGE volume (ml), gap number (GN), and average gap length (AGL [mm]). The gaps were defined as nonenhancement sites of >4 mm. The procedural factors including the catheter‐CF, stability, and orientation were calculated on the NavX system.ResultsSix (20%) of 30 patients had AF recurrences 12 months postablation. A univariate analysis demonstrated that the AGL was associated with AF recurrence (hazard ratio [HR]: 1.20, confidence interval [CI]: 1.03–1.42,p= .02). All AF recurrence were found in patients with an AGL of >7 mm. The catheter‐CF and stability were associated with an AGL of >7 mm, but not the orientation (CF—HR: 0.62, CI: 0.39–0.97,p= .038; stability—HR: 0.8, CI: 0.66–0.98,p= .027).ConclusionsRF ablation with a low CF and poor catheter stability has a potential risk of creating large lesion gaps associated with AF recurrence.
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影响因子：
24
作者：
Tan, Alex Y.;Li, Hongmei;Fishbein, Michael C.
通讯作者：
Fishbein, Michael C.
影响因子：
1.8
作者：
Parwani, Abdul S.;Hohendanner, Felix;Boldt, Leif-Hendrik
通讯作者：
Boldt, Leif-Hendrik
影响因子：
2.7
作者：
Akita, Tomomi;Kiuchi, Kunihiko;Hirata, Ken-Ichi
通讯作者：
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DOI：
--
发表时间：
2015
期刊：
Cardiovascular Electrophysiology
影响因子：
--
作者：
Shinsuke Miyazaki;H. Taniguchi;Hiroaki Nakamura;H. Hachiya;N. Ichihara;M. Araki;A. Kuroi;T. Takagi;J. Iwasawa;K. Hirao;Y. Iesaka
通讯作者：
Y. Iesaka
影响因子：
8.4
作者：
Nakagawa, Hiroshi;Ikeda, Atsushi;Jackman, Warren M.
通讯作者：
Jackman, Warren M.