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

在过去的十年中，我们对与器质性心脏病相关的心房颤动（Af）病例进行了术中心房测绘，并分析了电生理和临床数据。在这项研究中，我们继续这些调查，并开发了新的分析方法。为了可视化伴有或不伴有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”和“频繁”的激活，我们利用多点电极和特制的制图系统对心房颤动期间的心房电活动进行了制图。数据主要取自心房游离壁和解剖障碍，如肺静脉口或终末嵴，并通过专门设计的软件进行频谱分析。然后，我们利用电生理分析数据分析了肺静脉孔隔离（PVO1）的临床结果，这是我们开发并改进的一种微创简单手术方法。此外，我们通过实验和临床分析来检验外科射频消融的输送系统。术中Af重复激活的可视化对术中消融线的决定是有用的。临床和电生理数据分析结果表明，PVO1使心房电激活高度降低，两心房电激活表现出更多的器质性模式。可视化映射系统可以识别心房组织。我们相信这一结果对于慢性房颤的“订制程序”是有用的。此外，我们表明术中射频传输足以创建完整的消融线，该系统目前在实验和临床研究中使用。然而，我们注意到低能量输送可能使不完全阻塞线。因此，我们认为需要开发新的消融装置用于各种阻塞线或心外膜消融。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