Okubo Kenji, Kuwahara Taishi, Takagi Katsumasa, Takigawa Masateru, Nakajima Jun, Watari Yuji, Nakashima Emiko, Yamao Kazuya, Fujino Tadashi, Tsutsui Hiroyuki, Takahashi Atsushi
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan.
J Cardiovasc Electrophysiol. 2016 Jan;27(1):73-9. doi: 10.1111/jce.12823. Epub 2015 Sep 28.
The mapping of atrial tachycardia (AT) can often be challenging and time-consuming, especially in patients with ATs that develop following cardiac surgery or are concomitant with atrial fibrillation. Recently, a new multielectrode basket catheter (MBC) has become available; we hypothesized that the MBC could be utilized to diagnose AT circuits.
This study included 51 consecutive patients undergoing catheter ablation of clinically documented right-sided ATs (including 17 cases following cardiac surgery). Using a NavX system, 2 activation maps of the ATs were created, one using the new MBC (32 mm, 31 poles) and the other using a circular catheter. The time needed to complete the activation maps and the points acquired with both mapping catheters were compared. In all 64 ATs, including 34 non-cavotricuspid isthmus-dependent ATs, the AT activation maps created by both catheters were essentially identical. The number of points acquired to complete the activation maps did not differ significantly between the MBC and the circular catheter (387 [285-511] vs. 374 [269-533], P = 0.19), but the mapping time was significantly shorter using the MBC (4.0 [3.0-6.0] minutes vs. 8.0 [6.5-10.0] minutes, P < 0.0001). Inadvertent mechanical AT termination (n = 6) was observed only during mapping with the circular catheter.
In patients with right-sided ATs, the use of an MBC could save mapping time.
房性心动过速（AT）的标测通常具有挑战性且耗时，尤其是在心脏手术后发生或合并心房颤动的AT患者中。最近，一种新型多电极篮状导管（MBC）已投入使用；我们推测MBC可用于诊断AT环路。
本研究纳入了51例连续接受临床记录的右侧AT导管消融的患者（包括17例心脏手术后患者）。使用NavX系统创建了AT的2个激动标测图，一个使用新型MBC（32 mm，31极），另一个使用环状导管。比较了完成激动标测所需的时间以及两种标测导管获取的点数。在所有64例AT中，包括34例非腔静脉三尖瓣峡部依赖性AT，两种导管创建的AT激动标测图基本相同。MBC和环状导管完成激动标测获取的点数无显著差异（387 [285 - 511] 对374 [269 - 533]，P = 0.19），但使用MBC时标测时间显著缩短（4.0 [3.0 - 6.0]分钟对8.0 [6.5 - 10.0]分钟，P < 0.0001）。仅在使用环状导管标测期间观察到6例意外的机械性AT终止。
在右侧AT患者中，使用MBC可节省标测时间。
