Chen Ming-long, Zou Jian-gang, Xu Dong-jie, Yang Bing, Chen Chun, Shan Qi-jun, Li Wen-qi, Cao Ke-jiang
Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2005 Nov;33(11):971-4.
To evaluate the efficacy of left atrium linear lesion encircling pulmonary veins (PV) guided by EnSite-NavX and double-Lasso technique for paroxysmal atrial fibrillation (PAF).
Twenty-two patients (male 19, mean age of 48.5 years +/- 11.4 years) with symptomatic PAF were enrolled. After a geometry of the left atrium was reconstructed by EnSite-NavX system, PV ostia were marked on the map based on venography. Two Lasso catheters were placed within the ipsilateral superior and inferior PVs. Irrigated radiofrequency energy was applied at 0.5-1.0 cm of distance from the PV ostia. Continuous linear lesion was done to obtain the disappearance of pulmonary vein potentials. Patients were on propafenone and perindopril for three months after the procedure.
The endpoint for ablation was reached in 21 Patients and 1 patient was not successful because of cardiac tamponade. The mean procedure time was 6.6 h +/- 1.3 h and the mean X-ray exposure time was 56.1 min +/- 18.0 min. After a mean 5.3 months +/- 2.7 months of follow-up, 10 patients were free of symptoms. Two patients had no PAF recurrence after the second procedure. Three patients had clinical recurrence of PAF in the first month. The total success rate in this study was 81% (17/21). Mortality was 0% and the overall complication rate was about 9% (2/22).
Left atrium circumferential linear ablation surrounding PV ostia guided by EnSite-NavX and double-Lasso technique is effective in PAF, but some patients will need more than one procedure in order to achieve a success.
评估在EnSite-NavX和双套索技术引导下，左心房环绕肺静脉（PV）线性消融治疗阵发性心房颤动（PAF）的疗效。
纳入22例有症状的PAF患者（男性19例，平均年龄48.5岁±11.4岁）。通过EnSite-NavX系统重建左心房几何形状后，根据静脉造影在地图上标记PV口。将两根套索导管置于同侧上、下肺静脉内。在距PV口0.5-1.0 cm处施加灌注射频能量。进行连续线性消融以实现肺静脉电位消失。术后患者服用普罗帕酮和培哚普利三个月。
21例患者达到消融终点，1例因心脏压塞未成功。平均手术时间为6.6 h±1.3 h，平均X线照射时间为56.1 min±18.0 min。平均随访5.3个月±2.7个月后，10例患者无症状。2例患者第二次手术后无PAF复发。3例患者在第一个月出现PAF临床复发。本研究的总成功率为81%（17/21）。死亡率为0%，总体并发症发生率约为9%（2/22）。
在EnSite-NavX和双套索技术引导下，围绕PV口进行左心房环周线性消融治疗PAF有效，但部分患者需要进行不止一次手术才能成功。
