第二代 PVAC Gold 消融导管分段射频消融治疗心房颤动的 2 年结果。

2-year outcomes of phased radiofrequency ablation for atrial fibrillation with the second-generation PVAC Gold ablation catheter.

机构信息

Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.

Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, The Netherlands.

出版信息

J Interv Card Electrophysiol. 2022 Nov;65(2):471-480. doi: 10.1007/s10840-022-01249-2. Epub 2022 May 23.

PURPOSE

The second-generation multi-electrode catheter, PVAC Gold, was designed to improve the safe delivery of phased radiofrequency energy using a "single shot" approach for pulmonary vein isolation (PVI), while retaining efficacy. This large registry presents long-term performance in a daily practice setting.

METHODS

A total of 1011 patients undergoing first time ablation for atrial fibrillation (AF) using PVAC Gold were included, 639 patients with PVI for paroxysmal AF (PAF PVI) and 372 patients with persistent or long-standing persistent AF, divided into 175 patients receiving PVI only (PersAF PVI) and 197 patients receiving PVI with additional substrate ablation (PersAF PVI +).

RESULTS

At 24-month follow-up, single procedure freedom from atrial tachyarrhythmia (ATA) was 58% (368/639) in the PAF PVI group, 44% (77/175) in the PersAF PVI group, and 29% (57/197) in the PersAF PVI + group. Allowing one repeat procedure in 33% of patients, 76%, 65%, and 54% were free from ATA at 24 months, respectively. Pulmonary vein reconnection was observed in 98% of patients with recurrent arrhythmia after PVI.

CONCLUSIONS

Although phased RF ablation with PVAC Gold is quick and safe, the efficacy outcomes are modest compared to current mainstream ablation strategies.

目的

第二代多电极导管 PVAC Gold 的设计目的是通过“单次发射”的方法提高相位射频能量的安全输送，从而实现肺静脉隔离（PVI），同时保持疗效。该大型注册研究在日常实践环境中呈现了长期疗效。

方法

共纳入 1011 例首次使用 PVAC Gold 行消融术治疗心房颤动（AF）的患者，其中 639 例阵发性 AF（PAF PVI），372 例持续性或长程持续性 AF，分为仅行 PVI 的 175 例（PersAF PVI）和行 PVI 联合附加基质消融的 197 例（PersAF PVI+）。

结果

在 24 个月随访时，PAF PVI 组、PersAF PVI 组和 PersAF PVI+组单次消融程序无房性快速性心律失常（ATA）的比例分别为 58%（368/639）、44%（77/175）和 29%（57/197）。允许 33%的患者重复一次消融，24 个月时分别有 76%、65%和 54%的患者无 ATA。在 PVI 后出现心律失常复发的患者中，98%观察到肺静脉再连接。