Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
J Interv Card Electrophysiol. 2023 Jan;66(1):117-124. doi: 10.1007/s10840-022-01340-8. Epub 2022 Aug 12.
Previously, direct monitoring of local activation at the communicating vein (CV) has been reported to be useful for the ablation of ventricular arrhythmias (VAs) originating from the left ventricular (LV) summit. In this study, we evaluated the performance of the novel over-the-wire (OTW)-type decapolar catheter for VAs originating from the LV summit.
Overall, 17 patients who underwent catheter ablation for idiopathic VAs originating from the LV summit were included in this study. Of these, seven patients underwent mapping of the epicardial LV outflow tract with the novel 2.7 Fr OTW-type decapolar catheter (EPstar FIX AIV), and ten underwent mapping with the standard 2.0 Fr octopolar catheter (EPstar FIX 2F) procedure (AIV group = EPstar FIX AIV and control group = EPstar FIX 2F).
No significant differences in the baseline characteristics were observed between the two groups. In the AIV group, all patients achieved successful catheter positioning in the target CV, whereas in the control group, two patients failed to achieve the same. The novel catheter not only advanced to the target vessels using a 0.014-in guidewire but it was also used for contrast injection from the catheter lumen, which enabled accurate and safe positioning. As a result, the earliest activation time preceding QRS onset during the VA, recorded at the CV, was significantly earlier when compared with the control group (44.66 ± 11.23 ms vs. 32.16 ± 4.26 ms, P = 0.007).
Compared with the conventional electrode catheter, this novel multipolar electrode catheter is more effective for mapping local activation at the CV.
此前，已有研究报道直接监测交通静脉（CV）的局部激活对于消融起源于左心室（LV）心尖部的室性心律失常（VA）是有用的。在这项研究中，我们评估了新型经皮穿刺（OTW）型 10 极导管在起源于 LV 心尖部 VA 中的应用。
共有 17 例接受导管消融治疗起源于 LV 心尖部特发性 VA 的患者纳入本研究。其中，7 例行心外膜 LV 流出道标测采用新型 2.7Fr OTW 型 10 极导管（EPstar FIX AIV），10 例行标准 2.0Fr 8 极导管（EPstar FIX 2F）标测（AIV 组=EPstar FIX AIV，对照组=EPstar FIX 2F）。
两组患者的基线特征无显著差异。在 AIV 组，所有患者均成功将导管定位到目标 CV，而对照组有 2 例未能成功。新型导管不仅可在 0.014 英寸导丝引导下进入靶血管，还可通过导管腔进行对比剂注射，从而实现精确、安全的定位。结果，VA 时 CV 记录的 QRS 起始前最早激活时间明显早于对照组（44.66±11.23ms 比 32.16±4.26ms，P=0.007）。
与传统的电极导管相比，这种新型多极电极导管更有助于 CV 局部激活的标测。
