Saleem Moeen A, Burkett Scott, Passman Rod, Dibs Samer, Engelstein Erica D, Kadish Alan H, Goldberger Jeffrey J
Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Pacing Clin Electrophysiol. 2005 May;28(5):397-403. doi: 10.1111/j.1540-8159.2005.09547.x.
To evaluate the safety and efficacy of using a circular multielectrode catheter for mapping and ablation of ventricular tachycardia (VT) or premature ventricular complexes (PVCs) from the right ventricular outflow tract (RVOT).
Three-dimensional (3D) mapping systems are commonly used for mapping and ablation of RVOT VT and PVCs. Newer catheters that are circular with multiple electrodes, such as the Lasso catheter, are capable of simultaneously recording from multiple points within a circumferential plane. Given the tubular structure of the RVOT, these catheters could be used for mapping tachycardias from the RVOT.
A retrospective cohort study of patients undergoing radiofrequency (RF) ablation of RVOT VT or PVCs was performed. In group 1 (n = 7), mapping was performed with a single ablation catheter and fluoroscopy. In group 2 (n = 10), 3D mapping using ESI (n = 9) or CARTO (n = 1) was performed. In group 3 (n = 12), mapping was performed with a circular multielectrode catheter (n = 12). All ablations were performed with 4-mm tip catheters using RF energy.
Catheter ablation for RVOT VT (n = 15) or PVCs (n = 14) was performed on 29 cases in 26 patients, 9 males. Mean age was 35.9 years. In groups 1, 2, and 3, the mean number of lesions was 17.7 +/- 7.7, 13.6 +/- 7.7, and 18.2 +/- 22.7 and the median number of lesions was 20, 13, and 5, respectively. There were no significant differences in the number of lesions, RF time, fluoroscopy time, procedure time, and acute success rate among the three techniques. There were three complications in group 2 and one in group 3.
The use of a circular multielectrode catheter is as effective as the other standard available 3D mapping techniques, both in terms of procedural success and procedural characteristics. Additionally, because of the lower cost associated with using the circular multielectrode catheter approach, further evaluation should be performed to determine whether this is the most cost-effective approach to 3D mapping and ablation of RVOT tachycardias.
评估使用环形多电极导管对右心室流出道（RVOT）室性心动过速（VT）或室性早搏（PVC）进行标测和消融的安全性和有效性。
三维（3D）标测系统常用于RVOT室性心动过速和室性早搏的标测和消融。新型的带有多个电极的环形导管，如Lasso导管，能够在圆周平面内的多个点同时进行记录。鉴于RVOT的管状结构，这些导管可用于标测RVOT的心动过速。
对接受RVOT室性心动过速或室性早搏射频（RF）消融的患者进行回顾性队列研究。第1组（n = 7），使用单根消融导管并在透视下进行标测。第2组（n = 10），使用ESI（n = 9）或CARTO（n = 1）进行三维标测。第3组（n = 12），使用环形多电极导管（n = 12）进行标测。所有消融均使用4毫米尖端导管并采用射频能量。
对26例患者（9例男性）中的29例进行了RVOT室性心动过速（n = 15）或室性早搏（n = 14）的导管消融。平均年龄为35.9岁。在第1组、第2组和第3组中，平均消融灶数量分别为17.7±7.7、13.6±7.7和18.2±22.7，消融灶数量中位数分别为20、13和5。三种技术在消融灶数量、射频时间、透视时间、手术时间和急性成功率方面无显著差异。第2组有3例并发症，第3组有1例并发症。
就手术成功率和手术特点而言，使用环形多电极导管与其他现有的标准三维标测技术一样有效。此外，由于使用环形多电极导管方法的成本较低，应进一步评估以确定这是否是三维标测和消融RVOT心动过速最具成本效益的方法。
