Liu Xiao-Yu, Jacobsen Peter Karl, Pehrson Steen, Chen Xu
Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
J Invasive Cardiol. 2018 Apr;30(4):126-132. Epub 2017 Dec 15.
The outcomes of catheter ablation in focal atrial tachycardia (AT) using remote magnetic navigation (RMN) are still controversial. The objectives of this study were to assess the acute and long-term outcomes of catheter ablation in focal AT using RMN.
A total of 53 patients with focal AT who underwent catheter ablation using RMN were included. Thirty-six patients had structural heart disease, including previous atrial fibrillation ablation and heart surgery (abnormal group), and the remaining 17 patients had no structural heart disease (normal group).
In 53 patients, a total of 56 atrial foci were found. Acute success of the primary ablation was obtained in 52 patients (98%). Mean procedure duration was 109 ± 35 min, ablation duration was 401 sec (interquartile range [IQR], 332 sec), and fluoroscopy time was 5.0 min (IQR, 3.0 min). After a mean follow-up of 31 ± 18 months, 47 patients (89%) were free from focal AT. No major complications were observed. In the abnormal group, age and target atrium volume were higher and the left ventricular ejection fraction was lower when compared to the normal group. However, there were no significant differences in procedure duration (normal group 106 ± 31 min vs abnormal group 111 ± 37 min); ablation duration (normal group 457 sec [IQR, 412 sec] vs abnormal group 378 sec [IQR, 217 sec]); fluoroscopy time (normal group 4.2 min [IQR, 3.0 min] vs abnormal group 5.4 min [IQR, 3.3 min]); acute success rate (normal group 100% vs abnormal group 97%); and long-term success rate (normal group 88% vs abnormal group 89%) between the two groups (P>.05).
Our study has demonstrated that catheter ablation of focal AT using RMN is safe and effective, with low fluoroscopy exposure.
使用远程磁导航（RMN）进行局灶性房性心动过速（AT）导管消融的结果仍存在争议。本研究的目的是评估使用RMN进行局灶性AT导管消融的短期和长期结果。
共纳入53例接受RMN导管消融的局灶性AT患者。36例患者有结构性心脏病，包括既往房颤消融和心脏手术（异常组），其余17例患者无结构性心脏病（正常组）。
53例患者共发现56个房性病灶。52例患者（98%）初次消融获得急性成功。平均手术时间为109±35分钟，消融时间为401秒（四分位间距[IQR]，332秒），透视时间为5.0分钟（IQR，3.0分钟）。平均随访31±18个月后，47例患者（89%）无局灶性AT发作。未观察到重大并发症。与正常组相比，异常组年龄和目标心房容积更高，左心室射血分数更低。然而，两组之间在手术时间（正常组106±31分钟 vs 异常组111±37分钟）、消融时间（正常组457秒[IQR，412秒] vs 异常组378秒[IQR，217秒]）、透视时间（正常组4.2分钟[IQR，3.0分钟] vs 异常组5.4分钟[IQR，3.3分钟]）、急性成功率（正常组100% vs 异常组97%）和长期成功率（正常组88% vs 异常组89%）方面均无显著差异（P>0.05）。
我们的研究表明，使用RMN进行局灶性AT导管消融是安全有效的，透视暴露少。
