Maury Philippe, Champ-Rigot Laure, Rollin Anne, Mondoly Pierre, Bongard Vanina, Galinier Michel, Carrié Didier, Marminia Emilie, Capellino Stefano, Marty Lilian, Milliez Paul
Cardiology, University Hospital Rangueil, 31059, Toulouse Cedex 09, France.
Unité Inserm U 1048, Toulouse, France.
Heart Vessels. 2019 May;34(5):801-808. doi: 10.1007/s00380-018-1307-1. Epub 2018 Nov 19.
Ultra-high-density mapping allows very accurate characterization of circuits/mechanisms in atrial tachycardia (AT). Whether these advantages will translate into a better procedural or long-term clinical outcome is unknown. Sixty consecutive AT ablation procedures using ultra-high-density mapping (Rhythmia™, group 1) were retrospectively compared to 60 consecutive procedures using standard high-density mapping (Carto/NavX™, group 2) (total 209 AT, 79% left AT). A higher number of maps were performed in group 1 (4.8 ± 2.5 vs 3.2 ± 1.7, p = 0.0001) with similar acquisition duration (12 ± 5 vs 13 ± 6 min per map, p = ns), although with a greater number of activation points (10,543 ± 5854 vs 689 ± 1827 per map, p < 0.0001). AT location remained undetermined in 5 AT in group 1 vs 10 (p = 0.1). Mechanism remained undetermined in 5 AT from group 1 vs 11 (p = 0.06). Acute complete success was achieved in 77%, in both groups. At 1-year follow-up, AT recurred in 37% in group 1 vs 50% in group 2 (p = 0.046). There are less long-term recurrences after AT ablation using ultra-high-density mapping system compared to standard high-density 3D mapping, possibly because of a better comprehensive approach of AT mechanisms.
超高密度标测能够非常准确地表征房性心动过速（AT）的电路/机制。这些优势是否会转化为更好的手术或长期临床结果尚不清楚。对连续60例使用超高密度标测（Rhythmia™，第1组）的AT消融手术进行回顾性分析，并与连续60例使用标准高密度标测（Carto/NavX™，第2组）的手术进行比较（共209例AT，79%为左房AT）。第1组进行的标测数量更多（4.8±2.5对3.2±1.7，p=0.0001），采集持续时间相似（每张标测图12±5对13±6分钟，p=无统计学意义），尽管激活点数量更多（每张标测图10543±5854对689±1827，p<0.0001）。第1组有5例AT的位置未确定，第2组有10例（p=0.1）。第1组有5例AT的机制未确定，第2组有11例（p=0.06）。两组的急性完全成功率均为77%。在1年随访时，第1组AT复发率为37%，第2组为50%（p=0.046）。与标准高密度三维标测相比采用超高密度标测系统进行AT消融术后的长期复发率更低，这可能是因为对AT机制采用了更好的综合方法。
