Invasive management of atrial tachycardias using a novel lattice-tip catheter combining high-density mapping and dual ablation properties: initial real-world experience.

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-10-07 DOI:10.1007/s10840-024-01928-2
Ourania Kariki, Panagiotis Mililis, Athanasios Saplaouras, Theodoros Efremidis, Stylianos Dragasis, Konstantinos P Letsas, Michael Efremidis
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Abstract

Background: Invasive management of atrial tachycardias(ATs) requires proper diagnosis of the mechanism followed by elimination of the responsible substrate. A novel lattice-tip catheter with both high-density mapping and dual ablation properties(radiofrequency-RF/pulsed field ablation-PFA) has been recently introduced for catheter ablation of atrial fibrillation. We present the first study to assess its performance in the management of ATs (diagnostic and therapeutic).

Methods: Patients with documented ATs were selected. Activation mapping was used for the establishment of the AT mechanism. Confirmation with entrainment was performed, whenever appropriate. Accuracy of the activation mapping in diagnosis, acute ablation efficacy, and procedural characteristics were the study endpoints.

Results: Twenty patients were included (12 cavotricuspid isthmus-dependent atrial flutters, 5 mitral flutters, 2 roof flutters, and 2 focal ATs). Proper diagnosis was established by activation mapping in all cases. The mean mapping time was 7.85 ± 3.06 min with 296.82 ± 150.9 mean mapping points/minute. The mean ablation time was 54.25 ± 42.97 s. Conversion to sinus rhythm during ablation was achieved in all cases with the exception of a roof flutter that converted to mitral flutter and a case of a parahisian AT in which ablation was not attempted. Patients that received ablation did not experience any arrhythmia recurrence in a mean follow up of 4.14 ± 0.91 months. No major or minor complications occurred.

Conclusion: The lattice-tip catheter and its dedicated electroanatomical mapping system provided sufficiently detailed activation mapping for the diagnosis of the AT mechanism. The delivered lesions were highly effective acutely, with no adverse events. However, limitations exist and should be acknowledged.

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使用兼具高密度绘图和双重消融特性的新型格状尖端导管对房性心动过速进行有创治疗:初步实际体验。
背景:心房性心动过速(ATs)的侵入性治疗需要对其机制进行正确诊断,然后消除致病基质。最近推出了一种新型格状尖端导管,它具有高密度绘图和双重消融特性(射频-RF/脉冲场消融-PFA),可用于心房颤动的导管消融。我们首次对其在心房颤动治疗(诊断和治疗)中的性能进行了评估:方法:选择有记录的心房颤动患者。方法:选择有记录的心房颤动患者,使用激活图谱确定心房颤动机制。在适当的情况下,用夹带法进行确认。研究终点为活化图诊断的准确性、急性消融疗效和手术特点:共纳入 20 例患者(12 例腔窦峡部依赖性心房扑动、5 例二尖瓣扑动、2 例屋顶扑动和 2 例局灶性心房扑动)。所有病例的正确诊断都是通过激活图谱确定的。平均绘图时间为 7.85 ± 3.06 分钟,平均绘图点数为 296.82 ± 150.9 点/分钟。除一例房顶扑动转为二尖瓣扑动和一例副房室传导阻滞未尝试消融外,所有病例均在消融过程中转为窦性心律。接受消融术的患者在平均 4.14 ± 0.91 个月的随访期间未再出现心律失常。没有发生重大或轻微并发症:结论:格状尖端导管及其专用的电解剖映射系统可提供足够详细的激活映射,用于诊断心房颤动机制。输送的病灶急性期疗效显著,无不良反应。然而,这种方法也存在局限性,应予以承认。
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来源期刊
CiteScore
4.30
自引率
11.10%
发文量
320
审稿时长
4-8 weeks
期刊介绍: The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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