Local impedance-guided ablation and ultra-high density mapping versus conventional or contact force-guided ablation with mapping for treatment of cavotricuspid isthmus dependent atrial flutter.
Local impedance-guided ablation and ultra-high density mapping versus conventional or contact force-guided ablation with mapping for treatment of cavotricuspid isthmus dependent atrial flutter.
复制标题
局部阻抗引导消融和超高密度标测与常规或接触力引导消融和标测治疗三尖瓣峡部依赖的心房扑动。
DOI：
10.1016/j.ipej.2022.03.004
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发表时间：
2022-07
影响因子：
--
通讯作者：
Morris, Gwilym M
中科院分区：
文献类型：
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作者：
Saraf, Karan;Black, Nicholas;Garratt, Clifford J;Muhyaldeen, Sahrkaw A;Morris, Gwilym M
- 局部阻抗（LI）引导消融作为一种判断三尖瓣环峡部依赖性房扑（CTI-AFL）的损伤有效性的方法，以及在消融线上发生突破时的超高密度（UHD）标测，之前尚未进行过评估。这项回顾性观察性研究评价了使用传统、贴靠力（CF）和LI引导策略进行CTI-AFL消融的患者。收集消融指标，并在LI队列中，使用UHD标测评价突破。纳入30例患者，每组10例。LI组的平均总消融时间（3.2 ± 1.3分钟）显著短于传统组（5.6 ± 2.7分钟）和CF组（5.7 ± 2.0分钟，p = 0.0042）。从消融开始到三尖瓣环峡部阻滞的时间，LI组（14.2 ± 8.0 min）在数值上短于传统组和CF组（19.7 ± 14.1 min和22.5 ± 19.1 min，p = 0.4408）。LI组的平均病变持续时间明显较短，但在实现阻滞所需的病变数量、手术成功率、并发症发生率或复发率方面没有差异。15/30例患者在首过消融后未实现阻滞。UHD标测快速确定了5例LI患者的突破，包括心外膜-内膜突破（EEB）。- 消融期间使用LI进行实时病变评估与传统和CF方法一样有效。UHD测绘迅速发现了突破，包括EEB。典型的LI引导的消融至少与典型的心房扑动的常规和CF引导的消融一样有效和安全。超高密度标测快速和准确地识别突破，并且可以有助于减少消融时间。作者的Twitter句柄：Karan Saraf - @DrKaranSarafGwilym M Morris - @Dr_GwilymMorris。LI引导的CTI房扑消融至少与其他技术一样有效，具有潜在受益。UHD标测可快速识别突破，并可缩短消融时间。
– Local impedance (LI) guided ablation as a method of judging lesion effectiveness for cavotricuspid isthmus dependent atrial flutter (CTI-AFL), and ultra-high density (UHD) mapping when breakthrough occurred across an ablation line has not previously been assessed. This retrospective observational study evaluated patients undergoing CTI-AFL ablation using conventional, contact force (CF) and LI guided strategies. Ablation metrics were collected, and in the LI cohort, the use of UHD mapping for breakthrough evaluated. 30 patients were included, 10 per group. Mean total ablation time was significantly shorter with LI (3.2 ± 1.3min) vs conventional (5.6 ± 2.7min) and CF (5.7 ± 2.0min, p = 0.0042). Time from start of ablation to CTI block was numerically shorter with LI (14.2 ± 8.0min) vs conventional and CF (19.7 ± 14.1 and 22.5 ± 19.1min, p = 0.4408). Mean lesion duration was significantly shorter with LI, but there were no differences in the number of lesions required to achieve block, procedural success, complication rates or recurrence. 15/30 patients did not achieve block following first-pass ablation. UHD mapping rapidly identified breakthrough in the five LI patients, including epicardial-endocardial breakthrough (EEB). – The use of LI during ablation for real-time lesion assessment was as efficacious as the conventional and CF methods. UHD mapping rapidly identified breakthrough, including EEB. typical LI guided ablation is at least as effective and safe as conventional and CF guided ablation of typical atrial flutter Ultra-high density mapping rapidly and accurately identifies breakthrough and may contribute towards reduced ablation time. Twitter handles for authors:Karan Saraf - @DrKaranSarafGwilym M Morris - @Dr_GwilymMorris. LI-guided ablation of CTI-flutter is at least as effective as other techniques, with potential with potential benefits. UHD mapping rapidly identifies breakthrough and may reduce ablation time.