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单穿间隔穿刺技术与接触力导管:阵发性心房颤动的简化消融策略。

Single transseptal puncture technique and contact force catheter: A simplified ablation strategy for paroxysmal atrial fibrillation.

作者信息

Du Zhongpeng, Hu Feng, Wu Lingmin, Zheng Lihui, Ding Ligang, Liang Erpeng, Chen Gang, Yao Yan

机构信息

Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng, Beijing 100037, P.R. China.

出版信息

Exp Ther Med. 2020 Sep;20(3):2611-2616. doi: 10.3892/etm.2020.9087. Epub 2020 Aug 3.

Abstract

The present study aimed to evaluate the safety and efficacy of an optimized single transseptal puncture technique and contact force sensing atrial fibrillation (AF) radiofrequency catheter ablation (RFCA) strategy within a clinical setting. Fast anatomic mapping and contact force sensing ablation was applied to patients with paroxysmal AF (PAF) ablation between September 2014 and December 2016 using a single trans-septal sheath. Pulmonary vein isolation (PVI) and linear ablation were performed in PAF individually with a 10-20 g contact force with minimal fluoroscopy. Stimulation with 10 mA outputs on the lesions without capture was used as endpoint. A total of 419 consecutive patients who underwent first-time RFCA were enrolled in the current study, and acute PVI was achieved in all patients. The average procedure time was 74.5±9.7 min, with an average ablation time of 27.3±7.8 min. The average fluoroscopy time was 4.7±3.3 min and the average radiation dose was 24.3±25.2 mGy. At a mean follow-up time of 14.5 ± 4.1 months, sinus rhythm was maintained at 85.0%. Cardiac tamponade occurred in one case. The results indicated that this simplified technique was a simple, safe and effective approach for PAF ablation therapy.

摘要

本研究旨在评估在临床环境中优化的单次经房间隔穿刺技术和接触力感知心房颤动(AF)射频导管消融(RFCA)策略的安全性和有效性。2014年9月至2016年12月期间,对使用单根经房间隔鞘管进行阵发性房颤(PAF)消融的患者应用快速解剖标测和接触力感知消融。在PAF患者中分别进行肺静脉隔离(PVI)和线性消融,接触力为10 - 20克,荧光透视最少。以在病变处输出10毫安刺激且无夺获作为终点。本研究共纳入419例首次接受RFCA的连续患者,所有患者均实现了急性PVI。平均手术时间为74.5±9.7分钟,平均消融时间为27.3±7.8分钟。平均荧光透视时间为4.7±3.3分钟,平均辐射剂量为24.3±25.2毫戈瑞。平均随访时间为14.5±4.1个月时,窦性心律维持率为85.0%。发生心包填塞1例。结果表明,这种简化技术是PAF消融治疗的一种简单、安全且有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1d7/7418501/a0d48f9507f2/etm-20-03-2611-g00.jpg

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