Department of Cardiology, cNEP, Cardiac Neuro- & Electrophysiology Research Group, University Heart & Vascular Center Hamburg, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.
Future Cardiol. 2020 Nov;16(6):735-751. doi: 10.2217/fca-2020-0032. Epub 2020 Jul 1.
Ultra-high-density mapping (HDM) is increasingly used for guidance of catheter ablation in cardiac arrhythmias. While initial results are promising, a systematic evaluation of long-term outcome has not been performed so far. A systematic review and meta-analysis was conducted on studies investigating long-term outcome after Rhythmia HDM-guided atrial fibrillation (AF) or atrial tachycardia catheter ablation. Beyond multiple studies providing novel insights into arrhythmia mechanisms, follow-up data from 17 studies analyzing Rhythmia HDM-guided ablation (1768 patients, 49% with previous ablation) were investigated. Cumulative acute success was 100/90.2%, while 12 months long-term pooled success displayed at 71.6/71.2% (AF/atrial tachycardia). Prospective data are limited, showing similar outcome between HDM-guided and conventional AF ablation. Acute results of HDM-guided catheter ablation are promising, while long-term success is challenged by complex arrhythmogenic substrates. Prospective randomized trials investigating different HDM-guided ablation strategies are warranted and underway.
超高密度标测（HDM）越来越多地用于指导心律失常的导管消融。虽然最初的结果很有希望，但到目前为止，尚未对长期结果进行系统评估。
对研究 Rhythmia HDM 指导心房颤动（AF）或房性心动过速导管消融后长期结果的研究进行了系统回顾和荟萃分析。除了多项研究为心律失常机制提供了新的见解外，还对 17 项分析 Rhythmia HDM 引导消融的研究（1768 例患者，49%有既往消融）的随访数据进行了调查。急性成功率为 100/90.2%，而 12 个月的长期总体成功率为 71.6/71.2%（AF/房性心动过速）。前瞻性数据有限，表明 HDM 引导与常规 AF 消融之间的结果相似。HDM 引导导管消融的急性结果很有希望，但复杂的心律失常基质对长期成功构成挑战。需要并正在进行前瞻性随机试验，以研究不同的 HDM 引导消融策略。
