State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, No.167 North Lishi Rd, Xicheng, Beijing, 100037, People's Republic of China.
Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
BMC Cardiovasc Disord. 2022 Aug 3;22(1):352. doi: 10.1186/s12872-022-02790-8.
The KODEX-EPD system is a novel, dielectric three-dimensional mapping system. We aim to illustrate the feasibility, safety, and outcomes of ablation using the KODEX-EPD system.
A total of 272 patients with supraventricular arrhythmias were enrolled and underwent catheter ablation using the KODEX-EPD system from October 2020 to July 2021. The feasibility, safety, and ablation outcomes were analyzed.
Of the enrolled patients, 15 (5.4%) had atrial tachycardia (AT), 88 (31.4%) had atrioventricular reentrant tachycardia (AVRT), 141 (50.4%) had atrioventricular nodal reentrant tachycardia (AVNRT), 34 (12.1%) had atrial fibrillation (AF), and 9 (3.2%) had atrial flutter (AFL). All AF patients included were first-do-pulmonary vein isolation (PVI); there were 26 paroxysmal AF and 8 persistent AF. All patients achieved immediate success of ablation. The mean follow-up duration was 11.8 ± 2.4 months. One patient (1.1%) in the AVRT subgroup and two patients (1.4%) in the AVNRT subgroup experienced recurrence. When considering a three-month blanking time, the estimated freedom of AF at one-year post-ablation with and without AADs was 75.7% and 70.4%, respectively. The Kaplan-Meier analysis showed no significant difference in the overall AF recurrence (log-rank; P = 0.931) or AAD-free AF recurrence (log-rank; P = 0.841) between RFCA and cryoablation. One patient had mild pulmonary embolism. None of the patients died or had a cerebrovascular event in the periprocedural period.
This retrospective, two-center study demonstrated that catheter ablation of supraventricular arrhythmias using the KODEX-EPD system is feasible, safe, and effective. Trial registration Retrospectively registered.
KODEX-EPD 系统是一种新颖的介电三维标测系统。我们旨在阐述使用 KODEX-EPD 系统进行消融的可行性、安全性和结果。
2020 年 10 月至 2021 年 7 月，共有 272 例室上性心律失常患者接受 KODEX-EPD 系统导管消融治疗。分析了可行性、安全性和消融结果。
纳入的患者中，15 例（5.4%）为房性心动过速（AT），88 例（31.4%）为房室折返性心动过速（AVRT），141 例（50.4%）为房室结折返性心动过速（AVNRT），34 例（12.1%）为心房颤动（AF），9 例（3.2%）为心房扑动（AFL）。所有 AF 患者均为首次行肺静脉隔离（PVI）；其中 26 例为阵发性 AF，8 例为持续性 AF。所有患者均达到即刻消融成功。平均随访时间为 11.8±2.4 个月。AVRT 亚组中有 1 例（1.1%）、AVNRT 亚组中有 2 例（1.4%）患者复发。考虑 3 个月空白期，消融后 1 年无抗心律失常药物（AADs）和有 AADs 时 AF 的估计无复发率分别为 75.7%和 70.4%。Kaplan-Meier 分析显示，RFCA 与冷冻消融在总体 AF 复发（对数秩；P=0.931）或无 AAD 的 AF 复发（对数秩；P=0.841）方面无显著差异。1 例患者发生轻度肺栓塞。围术期内无患者死亡或发生脑血管事件。
这项回顾性、双中心研究表明，使用 KODEX-EPD 系统行导管消融治疗室上性心律失常是可行、安全且有效的。试验注册 回顾性注册。
