Jin Q I, Pehrson Steen, Jacobsen Peter Karl, Chen X U
Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Cardiovasc Electrophysiol. 2016 Mar;27 Suppl 1:S23-8. doi: 10.1111/jce.12929.
The objective of this study was to assess the procedural outcomes of catheter ablation guided by remote magnetic navigation (RMN) in a large cohort of patients with paroxysmal trial fibrillation (PAF) and persistent AF (PerAF).
A total of 726 patients (547 male, age: 58.5 ± 10.3 years) with symptomatic AF (61% PAF) were analyzed from a prospective ablation registry. Procedural parameters including pulmonary venous (PV) anatomy, left atrial (LA) volume, procedural time, ablation time, fluoroscopy time, total X-ray dose, and complications were assessed.
One thousand and six ablation procedures were analyzed. One-third of the patients (240/726) were ablated on more than one occasion, resulting in a mean of 1.3 ± 0.6 times for the entire group. When analyzing all procedures, the mean procedural time and ablation time was 134 ± 35 minutes and 2,130 ± 1,025 seconds, respectively. The mean fluoroscopy time was 5.4 ± 3.7 minutes. Compared to PAF patients, procedural time and ablation time were significantly increased in patients with PerAF by 10% (P < 0.001) and 19% (P < 0.001), respectively. However, fluoroscopy time was not increased (5.3 ± 3.5 minutes, PAF vs. 5.6 ± 4.0 minutes, PerAF, P = 0.17). The overall complication rate was 0.6%. One PAF patient experienced cardiac tamponade. AF repeat ablations by RMN significantly reduced the procedural and ablation times when compared with their first ablation times.
AF ablation guided by RMN is safe as evidenced by a low complication rate. Fluoroscopy time was relatively short for both PAF and PerAF ablation.
本研究的目的是评估在一大群阵发性房颤（PAF）和持续性房颤（PerAF）患者中，远程磁导航（RMN）引导下导管消融的手术结果。
从一个前瞻性消融登记处分析了总共726例有症状房颤患者（547例男性，年龄：58.5±10.3岁）（61%为PAF）。评估了包括肺静脉（PV）解剖结构、左心房（LA）容积、手术时间、消融时间、透视时间、总X线剂量和并发症在内的手术参数。
分析了1006例消融手术。三分之一的患者（240/726）接受了不止一次消融，整个组的平均次数为1.3±0.6次。分析所有手术时，平均手术时间和消融时间分别为134±35分钟和2130±1025秒。平均透视时间为5.4±3.7分钟。与PAF患者相比，PerAF患者的手术时间和消融时间分别显著增加了10%（P<0.001）和19%（P<0.001）。然而，透视时间没有增加（PAF为5.3±3.5分钟，PerAF为5.6±±4.0分钟，P=0.17）。总体并发症发生率为0.6%。一名PAF患者发生心脏压塞。与首次消融时间相比，RMN进行的房颤重复消融显著缩短了手术和消融时间。
RMN引导下的房颤消融并发症发生率低，证明是安全的。PAF和PerAF消融的透视时间相对较短。
