Davis Darryl R, Tang Anthony S L, Gollob Michael H, Lemery Robert, Green Martin S, Birnie David H
Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Pacing Clin Electrophysiol. 2008 Jul;31(7):893-8. doi: 10.1111/j.1540-8159.2008.01105.x.
It has been suggested that remote magnetic navigation (RMN) may provide enhanced catheter stability and substrate contact to aid in ablation. To date, no study has examined this claim. Accordingly, we compared the characteristics of the successful ablation of atrioventricular reentry tachycardia (AVNRT) using RMN with a matched population ablated using a conventional (CON) manual approach.
Sixteen patients who underwent RMN-assisted ablation of typical AVNRT were matched with 16 patients who had a CON-AVNRT ablation.
All patients had successful slow pathway modification without complication. The mean catheter temperature achieved with the successful ablation was significantly lower with RMN than with CON (42 +/- 7 degrees C vs 47 +/- 3 degrees C, P <or= 0.05). Time to junctional tachycardia (JT) was significantly earlier (5.7 +/- 4.1 s vs 11.2 +/- 8.9 s, P <or= 0.05) and variation in catheter temperature with the successful ablation (0.89 +/- 0.45 vs 1.45 +/- 0.49, P < 0.01) was significantly reduced in the RMN group than in the CON group. There was no significant difference between RMN and CON in terms of the total number of lesions and the mean power achieved during the successful lesion.
Although the construction of the ablation catheters is similar, ablations with RMN catheters resulted in a lower mean temperature, earlier time to JT, and less variability of temperature during ablation, suggesting greater catheter stability. This study indicates that ablation with RMN can achieve success with lower catheter temperatures.
有人提出远程磁导航(RMN)可能会增强导管稳定性并改善与基质的接触,从而有助于消融。迄今为止,尚无研究对这一说法进行验证。因此,我们比较了使用RMN成功消融房室折返性心动过速(AVNRT)的特征与使用传统(CON)手动方法消融的匹配人群的特征。
16例行RMN辅助消融典型AVNRT的患者与16例行CON-AVNRT消融的患者进行匹配。
所有患者均成功进行了慢径改良,且无并发症。成功消融时,RMN组的平均导管温度显著低于CON组(42±7℃对47±3℃,P≤0.05)。RMN组出现交界性心动过速(JT)的时间显著更早(5.7±4.1秒对11.2±8.9秒,P≤0.05),且成功消融时导管温度的变化(0.89±0.45对1.45±0.49,P<0.01)显著低于CON组。RMN组和CON组在总消融灶数量和成功消融灶期间达到的平均功率方面无显著差异。
尽管消融导管的构造相似,但使用RMN导管进行消融时平均温度更低、出现JT的时间更早,且消融期间温度变异性更小,表明导管稳定性更高。本研究表明,使用RMN进行消融可以在更低的导管温度下取得成功。