Rodríguez-Entem Felipe, Expósito Víctor, Rodríguez-Mañero Moisés, González-Enríquez Susana, Fernández-López Xesús Alberte, García-Seara Javier, Martínez-Sande José Luis, Olalla Juan José
Arrhythmia Unit, Cardiology Service, University Hospital Marques de Valdecilla, Santander, Spain.
Arrhythmia Unit, Cardiology Service, University Hospital Santiago, Santiago de Compostela, Spain.
J Arrhythm. 2016 Apr;32(2):95-101. doi: 10.1016/j.joa.2015.09.011. Epub 2015 Nov 24.
PV electrical isolation has become the cornerstone of catheter ablation for the treatment of atrial fibrillation (AF). Several strategies have been proposed to achieve this goal. The aim of this study was to assess the efficacy and safety of AF ablation using a new circular irrigated multielectrode ablation catheter designed to achieve single-delivery pulmonary vein (PV) isolation.
Thirty-five patients with drug refractory paroxysmal AF and normal ejection fraction from two centers were prospectively enrolled in this study. All patients underwent PV isolation with an nMARQ circular irrigated multielectrode ablation catheter guided by an electroanatomic mapping system. Magnetic resonance imaging was performed to exclude PV stenosis.
PV isolation was achieved in 138 of 140 (98.57%) targeted veins. The mean procedure time was 79.5 min (SD 39.3 min). During a mean follow up of 16.8±2.8 months, 27 of 35 (77.2%) patients were free of AF. No PV narrowing was observed. One case of pericardial effusion due to perforation of the left atrial free wall during catheter manipulation did occur.
PV isolation with a circular irrigated multielectrode ablation catheter is a feasible technique with a high acute success rate. The majority of patients remained asymptomatic during the midterm follow-up period. PV stenosis was not detected. While only a single serious adverse event occurred, this technique׳s safety profile should be tested in larger studies.
肺静脉电隔离已成为导管消融治疗心房颤动（房颤）的基石。为实现这一目标，已提出了多种策略。本研究的目的是评估使用一种新型环形灌注多电极消融导管进行房颤消融的有效性和安全性，该导管旨在实现一次输送完成肺静脉（PV）隔离。
前瞻性纳入来自两个中心的35例药物难治性阵发性房颤且射血分数正常的患者。所有患者在电解剖标测系统引导下，使用nMARQ环形灌注多电极消融导管进行肺静脉隔离。进行磁共振成像以排除肺静脉狭窄。
140条目标静脉中的138条（98.57%）实现了肺静脉隔离。平均手术时间为79.5分钟（标准差39.3分钟）。在平均16.8±2.8个月的随访期间，35例患者中有27例（77.2%）未发生房颤。未观察到肺静脉狭窄。确实发生了1例因导管操作期间左心房游离壁穿孔导致的心包积液。
使用环形灌注多电极消融导管进行肺静脉隔离是一种可行的技术，急性成功率高。大多数患者在中期随访期间仍无症状。未检测到肺静脉狭窄。虽然仅发生了1例严重不良事件，但该技术的安全性应在更大规模的研究中进行检验。
