Saef Joshua M, Burke Brendan J, Tchou Patrick J, Aziz Peter F
Department of Cardiology, Cleveland Clinic Foundation, Cleveland, OH, USA.
Department of Pediatrics, Cleveland Clinic Children's, Cleveland, OH, USA.
J Innov Card Rhythm Manag. 2021 Sep 15;12(9):4657-4669. doi: 10.19102/icrm.2021.120901. eCollection 2021 Sep.
The Rhythmia™ system (Boston Scientific, Natick, MA, USA) facilitates the rapid acquisition of high-resolution electroanatomical and activation maps. However, there are limited data on its efficacy and safety in pediatric and adult congenital heart disease (CHD) patients. In a retrospective, observational cohort study, adult CHD and pediatric patients followed by pediatric cardiology underwent electrophysiologic study using the Rhythmia™ electroanatomic mapping system. Variables examined included the number of electroanatomical maps required, acquisition time, procedure time, fluoroscopy time, radiation dosage, and rate of recurrent arrhythmia. Twelve consecutive patients, including six male patients (50%), were included with an average age of 27.7 years (range: 11-64 years). Seven (58%) of these patients had a diagnosis of CHD [moderate complexity in two (17%) and great complexity in five patients (42%)] and 10 (83%) patients underwent ablation. A total of 37 high-density maps were created in 12 procedures, with a median of 8,140 mapping points, taking a median of 631 seconds. The median procedure time was 189.5 minutes. The median fluoroscopy time was 0.9 minutes, with eight (67%) patients receiving no fluoroscopy at all. Recurrence occurred in one patient (8%) over a median follow-up duration of 16 months (interquartile range: 12.8-17.3 months). No adverse periprocedural events were recorded. This study suggests the use of high-density electroanatomic mapping in adult CHD patients showed potential for rapid acquisition of highly detailed maps with minimal fluoroscopy time or risk of periprocedural events in the studied population.
Rhythmia™ 系统（美国波士顿科学公司，马萨诸塞州纳蒂克）有助于快速获取高分辨率电解剖图和激动标测图。然而，关于其在小儿和成人先天性心脏病（CHD）患者中的疗效和安全性的数据有限。在一项回顾性观察队列研究中，接受小儿心脏病学随访的成人CHD患者和小儿患者使用Rhythmia™ 电解剖标测系统进行了电生理研究。检查的变量包括所需电解剖图的数量、采集时间、手术时间、透视时间、辐射剂量和心律失常复发率。连续纳入12例患者，其中包括6例男性患者（50%），平均年龄为27.7岁（范围：11 - 64岁）。这些患者中有7例（58%）被诊断为CHD [2例（17%）为中度复杂，5例（42%）为高度复杂]，10例（83%）患者接受了消融治疗。在12例手术中总共创建了37张高密度图，中位数为8140个标测点，中位数采集时间为631秒。手术时间中位数为189.5分钟。透视时间中位数为0.9分钟，8例（67%）患者根本没有接受透视。在中位随访期16个月（四分位间距：12.8 - 17.3个月）内，1例患者（8%）出现复发。未记录围手术期不良事件。这项研究表明，在成人CHD患者中使用高密度电解剖标测有可能在研究人群中以最短的透视时间或围手术期事件风险快速获取高度详细的图谱。
