房颤的导管消融。新型多极消融导管在肺静脉隔离中的应用

Stefan G Spitzer, Laszlo Karolyi
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引用次数: 1

摘要

心房颤动(AF)的导管消融是一种既定的治疗选择,特别是在治疗阵发性心房颤动。本文介绍了使用PVAC多电极消融导管(PVAC®,Medtronic ablation Frontiers, Carlsbad, CA, USA)的结果。253例阵发性或持续性房颤患者,共分离肺静脉1051条,其中左总口34条,右总口1条。除1条静脉外,所有患者均成功分离肺静脉。在23例有典型心房扑动记录的患者中,在相同的手术中,右心房峡部被额外消融。随访时间分别为1、3、6和12个月,分别为12导联心电图、24小时动态心电图和4天动态心电图。平均FU为11±7个月,每例患者1.1次干预(24例重复)。在FU期间,181例阵发性房颤患者中的122例(69%)和40例持续性房颤患者中的23例(58%)在消融后处于稳定窦性心律(SR)。159例(62.8%)患者在消融后服用抗心律失常药物,214例(84.5%)患者额外服用β受体阻滞剂。总手术时间71±19 min,总透视时间16±6 min,发生手术相关并发症3例(1.2%)。pvac消融导管隔离肺静脉是治疗阵发性和持续性房颤的一种安全有效的方法。
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[Catheter ablation of atrial fibrillation. Pulmonary vein isolation by using a new multipolar ablation catheter].

Catheter ablation of atrial fibrillation (AF) is an established therapeutical option, particularly in treatment of paroxysmal atrial fibrillation. This paper presents the results of using the PVAC multi-electrode ablation catheter (PVAC®, Medtronic Ablation Frontiers, Carlsbad, CA, USA). In 253 patients with paroxysmal or persistant AF, 1051 pulmonary veins were isolated, including ablation of 34 left common ostia and 1 right common ostium. Except one vein, all pulmonary veins in all patients were successfully isolated. In 23 patients with documented typical atrial flutter, the right atrial isthmus was additionally ablated within the same procedure. Follow-up (FU) visits were performed after 1, 3, 6 and 12 months with 12-lead-ECG, 24h-Holter-ECG and 4-days-Holter ECG. Mean FU was 11 ± 7 months with 1.1 interventions per patient (24 redo cases). During FU, 122 of 181 patients with paroxysmal AF (69%) and 23 of 40 patients with persistant AF (58%) were in stable sinus rhythm (SR) after ablation. 159 (62.8%) patients wer under antiarrhythmic drugs after ablation, 214 (84.5%) patients with additional β-blockers. Total procedure time was 71 ± 19 min, and total fluoroscopy time was 16 ± 6 min. In 3 cases (1.2%) procedure-related complications occured. Pulmonary vein isolation by using the PVAC-ablation catheter is a safe and effective method in treatment of paroxysmal and persistant AF.

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Clinical Research in Cardiology Supplements
Clinical Research in Cardiology Supplements Medicine-Radiology, Nuclear Medicine and Imaging
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