Fu Guohua, He Bin, Wang Binhao, Feng Mingjun, Du Xianfeng, Liu Jing, Yu Yibo, Gao Fang, Zhuo Weidong, Xu Yi, Qi Yingbo, Chu Huimin
Arrhythmia Center, Ningbo First Hospital, Ningbo 315000, China.
Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo 315000, China.
J Cardiovasc Dev Dis. 2022 Jul 18;9(7):229. doi: 10.3390/jcdd9070229.
Background: This research explores the relationship between the unipolar electrogram (UP-EGM) and lesion size index (LSI) in different regions of continuous circular lesions (CCLs) and to assess the safety and efficacy of UP-EGM-guided versus LSI-guided radiofrequency catheter ablation (RFCA) in patients with paroxysmal atrial fibrillation (PAF). Methods: A total of 120 patients with drug-refractory PAF who underwent index RFCA were scheduled to be consecutively included from March 2020 to April 2021. All the patients were randomly divided 1:1 into two groups: the UP-EGM group and the LSI group. The first-pass PVI rate, acute PVI rate, and the sinus rhythm maintenance rate were compared. Results: A total of 120 patients with PAF were included in the study: the UP-EGM group (n = 60) and the LSI group (n = 60). All the LSI values in the UP-EGM group were less than those in the corresponding regions in the LSI group (all p < 0.001). There were no significant differences in the first-pass PVI rate and acute PVI rate between the two groups. After a mean follow-up period of 11.31 ± 1.70 months, the sinus rhythm maintenance rate in the UP-EGM group was comparable to that in the LSI group (90% vs. 91.7%, p = 0.752). Conclusion: UP-EGM-guided and LSI-guided RFCA are both effective and safe in patients with PAF. However, UP-EGM may be more suitable than LSI for guiding individual RFCA.
本研究探讨连续环形损伤（CCLs）不同区域单极电图（UP-EGM）与损伤大小指数（LSI）之间的关系，并评估UP-EGM引导与LSI引导的射频导管消融（RFCA）对阵发性心房颤动（PAF）患者的安全性和有效性。方法：2020年3月至2021年4月，共纳入120例接受初次RFCA治疗的药物难治性PAF患者。所有患者按1:1随机分为两组：UP-EGM组和LSI组。比较首次肺静脉隔离（PVI）率、急性PVI率和窦性心律维持率。结果：本研究共纳入120例PAF患者：UP-EGM组（n = 60）和LSI组（n = 60）。UP-EGM组的所有LSI值均低于LSI组相应区域的值（均p < 0.001）。两组的首次PVI率和急性PVI率无显著差异。平均随访11.31±1.70个月后，UP-EGM组的窦性心律维持率与LSI组相当（90%对91.7%，p = 0.752）。结论：UP-EGM引导和LSI引导的RFCA对PAF患者均有效且安全。然而，UP-EGM可能比LSI更适合指导个体化RFCA。
