Acute success and short-term follow-up of catheter ablation of isthmus-dependent atrial flutter; a comparison of 8 mm tip radiofrequency and cryothermy catheters.
Acute success and short-term follow-up of catheter ablation of isthmus-dependent atrial flutter; a comparison of 8 mm tip radiofrequency and cryothermy catheters.
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DOI：
10.1007/s10840-008-9209-2
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发表时间：
2008-04
影响因子：
1.8
通讯作者：
Jordaens, L.
中科院分区：
文献类型：
--
作者：
Thornton, A. S.;Janse, P.;Alings, M.;Scholten, M. F.;Mekel, J. M.;Miltenburg, M.;Jessurun, E.;Jordaens, L.
比较使用8 mm尖端射频（RF）和冷冻导管消融房扑的即刻成功率和短期随访。62例心房扑动患者随机接受射频或冷冻导管（冷冻）消融。进行右心房血管造影以评估峡部。终点为双向峡部阻滞（多个标准）。使用疼痛评分并记录镇痛药。患者随访至少3个月。RF的即刻成功率为83%，冷冻（NS）为69%。手术时间相似（RF平均144 ± 48 min，冷冻平均158 ± 49 min）。射频组的应用次数多于冷冻组（26 ± 17 vs. 18 ± 10，p < 0.05）。RF的透视时间更长（29 ± 15分钟与19 ± 12分钟，p < 0.02）。在冷冻组中，峰值CK、CK-MB和CK-MB质量在24 h后也较高。肌钙蛋白T无差异。应用过程中反复出现短暂性阻滞（通常与冷冻消融术一起使用）似乎可以预测失败。冷冻需要的镇痛显著较少（p < 0.01），并且不使用长鞘管（p < 0.005）。失败手术的峡部往往更长（p = 0.117）。两组的情况相似，解剖变异的分布也相似。两组成功患者的复发率和主诉相似，初次成功后房扑复发率非常低。在这项随机研究中，与射频导管相比，8 mm头端冷冻导管用于房扑消融的结局不太有利，但无统计学差异。冷冻消融术的不适感更轻、应用更少、荧光透视时间更短且手术时间相似。复发率很低。在某些情况下，可以考虑将冷冻疗法用于房扑消融术，特别是当先前已在同一患者中使用过冷冻疗法时，例如在AF消融术中。
To compare the acute success and short-term follow-up of ablation of atrial flutter using 8 mm tip radiofrequency (RF) and cryocatheters. Sixty-two patients with atrial flutter were randomized to RF or cryocatheter (cryo) ablation. Right atrial angiography was performed to assess the isthmus. End point was bidirectional isthmus block on multiple criteria. A pain score was used and the analgesics were recorded. Patients were followed for at least 3 months. The acute success rate for RF was 83% vs 69% for cryo (NS). Procedure times were similar (mean 144 ± 48 min for RF, vs 158 ± 49 min for cryo). More applications were given with RF than with cryo (26 ± 17 vs. 18 ± 10, p < 0.05). Fluoroscopy time was longer with RF (29 ± 15 vs. 19 ± 12 min, p < 0.02). Peak CK, CK-MB and CK-MB mass were higher, also after 24 h in the cryo group. Troponin T did not differ. Repeated transient block during application (usually with cryoablation) seemed to predict failure. Cryothermy required significantly less analgesia (p < 0.01), and no use of long sheaths (p < 0.005). The isthmus tended to be longer in the failed procedures (p = 0.117). This was similar for both groups, as was the distribution of anatomic variations. Recurrences and complaints in the successful patients were similar for both groups, with a very low recurrence of atrial flutter after initial success. In this randomized study there was no statistical difference but a trend to less favorable outcome with 8 mm tip cryocatheters compared to RF catheters for atrial flutter ablation. Cryoablation was associated with less discomfort, fewer applications, shorter fluoroscopy times and similar procedure times. The recurrence rate was very low. Cryotherapy can be considered for atrial flutter ablation under certain circumstances especially when it has been used previously in the same patient, such as in an AF ablation.
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影响因子：
37.8
作者：
Manusama, R;Timmermans, C;Rodriguez, LM
通讯作者：
Rodriguez, LM
DOI：
10.1007/s10840-005-5840-3
发表时间：
2005-01-01
影响因子：
1.8
作者：
Montenero, AS;Bruno, N;Affinito, V
通讯作者：
Affinito, V
影响因子：
6.1
作者：
Posan, Emoke;Redfearn, Damian P.;Skanes, Allan C.
通讯作者：
Skanes, Allan C.
影响因子：
5.7
作者：
Bertaglia, E;Zoppo, F;Pascotto, P
通讯作者：
Pascotto, P
影响因子：
2.8
作者：
Calkins, H;Canby, R;Onufer, J
通讯作者：
Onufer, J