Efficacy and safety of segmental ostial versus circumferential extra-ostial pulmonary vein isolation for atrial fibrillation
Efficacy and safety of segmental ostial versus circumferential extra-ostial pulmonary vein isolation for atrial fibrillation
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DOI：
10.1046/j.1540-8167.2004.03503.x
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发表时间：
2004-05-01
影响因子：
2.7
通讯作者：
Keane, D
中科院分区：
文献类型：
--
作者：
Mansour, M;Ruskin, J;Keane, D
房颤的肺静脉隔离术简介：房颤的肺静脉隔离术可以采用节段性开口或环周性开口外入路。目前正在辩论每种方法的相对优点和潜在局限性。在这里，我们报告我们的早期经验，这些方法，包括其相对的疗效和safety.Methods和结果：40例药物难治性房颤患者进行了节段性开口PV隔离，并进行了比较，40例连续的患者进行PV隔离使用圆周口外的方法。本文描述的后一种方法在两个方面是新颖的：（1）消融终点是肺静脉隔离，而不仅仅是左心房到肺静脉传导时间的延迟，（2）通过单次环绕同侧静脉实现了右肺静脉和左肺静脉的隔离。随访时，节段性组60%的患者无AF，环周性组75%的患者无AF。有一个血栓栓塞性脑血管并发症在每个group.Conclusion消融procedure过程中：PV隔离使用的圆周口外的方法，其中同侧PV隔离在一起，由一个环绕线的块，使用电解剖标测，是一个技术上可行的程序。这种方法至少与更成熟的节段性开口入路房颤消融一样有效和安全。
Pulmonary Vein Isolation for AF. Introduction: Pulmonary vein (PV) isolation for atrial fibrillation (AF) can be performed using a segmental ostial or a circumferential extra-ostial approach. The relative merits and potential limitations of each approach are currently debated. Here we report our early experience with each of these approaches, including their relative efficacy and safety.Methods and Results: Forty patients with drug-refractory AF underwent segmental ostial PV isolation and were compared to 40 consecutive patients who underwent PV isolation using a circumferential extraostial approach. The latter approach described here is novel in two aspects: (1) the endpoint for ablation was PV isolation and not only delay in left atrial to PV conduction time, and (2) isolation of the right and left PVs was achieved by a single encirclement of ipsilateral veins. At follow-up, 60% of the patients in the segmental group were free of AF compared to 75% of the patients in the circumferential group. There was one thromboembolic cerebrovascular complication during the ablation procedure in each group.Conclusion: PV isolation using a circumferential extra-ostial approach, where the ipsilateral PVs are isolated together by one encircling line of block using electroanatomic mapping, is a technically feasible procedure. This approach is at least as effective and safe as the more established segmental ostial approach for AF ablation.