Cardiac Thoracic and Vascular Department - University Hospital of Pisa.
Department of Cardiology, Sant'Ambrogio Clinical Institute.
Circ J. 2018 Mar 23;82(4):974-982. doi: 10.1253/circj.CJ-17-0421. Epub 2018 Feb 8.
Our aim was to evaluate the clinical outcome of paroxysmal atrial fibrillation (AF) ablation with contact force technology, using an automated lesion tagging system (VISITAG module) with strict criteria of catheter stability.
We enrolled 200 consecutive patients who underwent pulmonary vein isolation (PVI) in 11 centers and were followed up for 12 months. The stability setting was within 3 mm for ≥10 s and for ≥15 s in 47% and 53% of patients, respectively. A mean of 67.2±21.9 VISITAGs was acquired. Freedom from atrial tachyarrhythmias at follow-up was 77.5% (155/200), and the contiguity between lesions was associated with a higher chronic success rate (96% vs. 77.1%; log-rank P=0.036). Radiofrequency (RF), fluoroscopy times, and recurrence rates at the 12-month follow-up were significantly lower than in a comparison group of 80 patients without VISITAG module (42.7±14.5 vs. 50.9±23.6 min; P=0.032; 11.6±7.8 vs. 18.4±12.8 min; P=0.003 and 22.5% vs. 41.2%; P=0.02). Two major complications (1 cardiac tamponade and 1 minor stroke) were observed only in the control group.
Paroxysmal AF ablation with contact force technology and strict criteria of stability using the VISITAG module was a safe procedure, associated with an improvement in efficiency and a reduction of atrial tachyarrhythmia recurrence at the 12-month follow-up compared with manual annotation. Contiguity between lesions seemed to enhance effectiveness outcomes.
我们的目的是评估使用接触力技术和严格的导管稳定性标准（VISITAG 模块）进行阵发性心房颤动（AF）消融的临床结果。
我们招募了 200 名连续患者，这些患者在 11 个中心接受了肺静脉隔离（PVI）治疗，并随访了 12 个月。稳定性设置为在≥10 秒内保持在 3mm 内，分别有 47%和 53%的患者满足≥15s 的要求。平均获得 67.2±21.9 个 VISITAG。随访时无房性心动过速的比例为 77.5%（155/200），病变的连续性与较高的慢性成功率相关（96%比 77.1%；log-rank P=0.036）。射频（RF）、透视时间和 12 个月时的复发率明显低于 80 名没有 VISITAG 模块的对照组（42.7±14.5 比 50.9±23.6 分钟；P=0.032；11.6±7.8 比 18.4±12.8 分钟；P=0.003 和 22.5%比 41.2%；P=0.02）。仅在对照组中观察到 2 例主要并发症（1 例心脏压塞和 1 例轻度中风）。
使用接触力技术和 VISITAG 模块严格的稳定性标准进行阵发性 AF 消融是一种安全的方法，与手动标注相比，在 12 个月的随访中可提高效率，降低房性心动过速的复发率。病变之间的连续性似乎可以增强疗效。
