局灶性房性心动过速的射频消融：与传统标测相比，电解剖标测的优势

Radiofrequency ablation of focal atrial tachycardia: Benefit of electroanatomical mapping over conventional mapping.

作者信息

Szegedi N, Zima E, Clemens M, Szekely A, Kiss R G, Szeplaki G, Geller L, Merkely B, Csanadi Z, Duray G

机构信息

Heart and Vascular Center, Semmelweis University , Budapest , Hungary.

Cardiology Institute, University of Debrecen , Debrecen , Hungary.

出版信息

Acta Physiol Hung. 2015 Sep;102(3):252-62. doi: 10.1556/036.102.2015.3.3.

DOI:10.1556/036.102.2015.3.3

PMID:26551741

Abstract

BACKGROUND

Catheter ablation is a proven therapy of focal atrial tachycardia. However limited information is available about the additional value of electroanatomical over conventional mapping methods for this specific arrhythmia.

METHODS

Consecutive catheter ablation procedures of FAT were analyzed in two cardiology centres. Only conventional mapping was used in 30 of the 60 procedures whereas additionally CARTO mapping was performed in another 30 procedures. Acute, six-month success rate, and procedural data were analyzed.

RESULTS

Localization of ectopic foci is congruent with previously published data. There was no statistically significant difference between procedure time and fluoroscopy time using additionally CARTO mapping, compared to conventional mapping only. Acute success rate was higher in procedures guided by CARTO mapping than in procedures based on conventional mapping (27/30 vs. 18/30, p = 0.0081). During the 6-month follow-up period there was a better outcome (p = 0.045) in case of CARTO guided procedures (success: 11 cases, partial success: 12 cases, failure: 4 cases) compared to conventional mapping (success: 4 cases, partial success: 18 cases, failure: 7 cases).

CONCLUSIONS

Catheter ablation of focal atrial tachycardias using the CARTO electroanatomical mapping system seems to provide higher acute and 6-month success rate compared to ablation using conventional mapping methods only.

摘要

背景

导管消融是一种已被证实的局灶性房性心动过速治疗方法。然而，关于电解剖标测相对于传统标测方法在这种特定心律失常中的附加价值，可用信息有限。

方法

对两个心脏病中心连续进行的局灶性房性心动过速导管消融手术进行分析。60例手术中，30例仅使用传统标测，另外30例还进行了CARTO标测。分析了急性成功率、6个月成功率和手术数据。

结果

异位灶的定位与先前发表的数据一致。与仅使用传统标测相比，额外使用CARTO标测时，手术时间和透视时间没有统计学上的显著差异。CARTO标测引导的手术急性成功率高于基于传统标测的手术（27/30对18/30，p = 0.0081）。在6个月的随访期内，与传统标测（成功：4例，部分成功：18例，失败：7例）相比，CARTO引导的手术（成功：11例，部分成功：12例，失败：4例）有更好的结果（p = 0.045）。