Study of underlying electrical pattern of chronic atrial fibrillation and development of new surgical radio-frequency ablation system

我们在过去十年中对器质性心脏病合并心房颤动（Af）的病例进行了术中心房标测，并分析了电生理和临床资料。本研究在此基础上，发展了新的分析方法，利用多点电极和特制的标测系统，从心房表面标测心房颤动时的心房电活动，以直观地观察伴或不伴器质性心脏病的慢性心房颤动（Af）的电生理特征，特别是“重复性”和“频繁性”激动。数据主要采集自两个心房的心房游离壁和解剖障碍物，如肺静脉口或界嵴，并通过专门设计的软件进行频谱分析。然后，我们分析了肺静脉口隔离术（PVO 1）的临床结果，PVO 1是我们开发并实施的一种微创简单手术， ...更多信息 对于慢性房颤，根据电生理学分析的数据进行修正。此外，我们通过实验和临床分析对外科射频消融的输送系统进行了研究，术中观察Af的重复激活有助于术中消融线的确定。临床和电生理资料分析结果表明，PVO 1使Af显著降低，在两种心房电激动中均表现出更多的器质性模式。可视化标测系统可以识别心房组织。我们认为这一结果对于慢性房颤的“订单手术”是有用的。另外，我们在实验和临床研究中表明，术中射频输送足以使用目前使用的系统创建完整的消融线。然而，我们注意到，低能量输送可能会使阻塞线不完整。因此，我们认为需要开发新的消融装置，用于各种阻滞线或心外膜消融。少

We have performed intraoperative atrial mapping in the cases of atrial fibrillation (Af) associated with organic heart disease and analyzed electrophysiological and clinical data in last decade. In this study, we continued these investigations and developed new analysis methods.To visualize the electrophysiological characteristics, especially the "repetitive" and "frequent" activation, of chronic atrial fibrillation (Af) associated with or without organic heart disease, we mapped atrial electrical activity from atrial surface during atrial fibrillation by means of multi-point electrodes and specially made mapping system. Data were mainly acquired from the atrial free wall of both atria and anatomical obstacles, such as the orifice of pulmonary veins or crista terminalis, and were analyzed by specially designed software using spectrum analysis. Then we analyzed clinical outcome of pulmonary vein orifice isolation (PVO1), a less invasive simple surgical procedure that we developed and pe … More rformed, for chronic Af wilh the data from electrophysiological analysis. Moreover, we examined the delivery system of surgical radio frequency ablation with experimental and clinical analysis.Intraoperative visualization of repetitive activation of Af was useful for intraoperative decision of the ablation line. The results of analysis from clinical and electrophysiological data suggested that Af was highly diminished with PVO1, which showed more organic pattern in both atrial electric activation. The visualization mapping system can recognize the atrial organization. We believe that this outcome is useful for "Order Made Procedure" for chronic Af.Otherwise, we showed that the intraoperative radio frequency delivering was enough to create complete ablation line with the system now in use in the experimental and clinical study. However, we noted that low energy delivery possibly make incomplete block line. Then we supposed that the development of new ablation device for various block lines or for epicardial ablation is needed. Less