Maurer Tilman, Flindt Max, Jularic Mario, Lemes Christine, Akbulak-Stegli Ruken Özge, Gunawardene Melanie A, Hartmann Jens, Eickholt Christian, Willems Stephan, Schäffer Benjamin
Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
J Cardiovasc Electrophysiol. 2022 Dec;33(12):2467-2472. doi: 10.1111/jce.15705. Epub 2022 Oct 26.
Recently, the wide-band dielectric mapping system Kodex-EPD was introduced. This study reports the first clinical experience using a novel system to guide pulmonary vein isolation (PVI) with radiofrequency (RF) ablation. METHODS AND RESULTS: The study included 20 consecutive patients undergoing de-novo PVI for symptomatic paroxysmal or persistent atrial fibrillation guided by Kodex-EPD. The primary efficacy endpoint was successful PVI. Secondary endpoints included procedural parameters and complications. In all 20 patients (mean age 68 ± 8 years, 12 male patients, paroxysmal fibrillation in 14/20 [70%] patients), PVI was successfully completed. One patient underwent additional cavo-tricuspid isthmus ablation for concomitant typical atrial flutter and one patient required additional ablation of a focal atrial tachycardia. A conventional three-dimensional image of the left atrium as well as the innovative endocardial panoramic view were used to guide catheter manipulation and ablation. Median procedure time was 115 [1st; 3rd quartile 93,75; 140] min and median total fluoroscopy time was 9.9 [9.7; 11.2] min, of which a median of 0.8 [0.6; 0.9] min was required to create left atrial maps. Complete left atrial imaging using Kodex-EPD was achieved within a median of 7.1 [5.7; 8.3] min. Median RF ablation time was 45.1 [34.6; 58.7] min. No major complications were observed.
RF ablation PVI guided by Kodex-EPD seems safe and feasible. The system provides effective three-dimensional guidance for PVI.
最近，宽带介电标测系统Kodex-EPD被引入。本研究报告了使用一种新型系统通过射频（RF）消融指导肺静脉隔离（PVI）的首次临床经验。
该研究纳入了20例连续接受由Kodex-EPD指导的症状性阵发性或持续性心房颤动初次PVI的患者。主要疗效终点是成功的PVI。次要终点包括手术参数和并发症。在所有20例患者（平均年龄68±8岁，12例男性患者，14/20 [70%] 例患者为阵发性房颤）中，PVI均成功完成。1例患者因合并典型心房扑动接受了额外的腔静脉-三尖瓣峡部消融，1例患者需要额外消融局灶性房性心动过速。使用左心房的传统三维图像以及创新的心内膜全景视图来指导导管操作和消融。中位手术时间为115 [第1；第3四分位数93.75；140] 分钟，中位总透视时间为9.9 [9.7；11.2] 分钟，其中创建左心房图的中位时间为0.8 [0.6；0.9] 分钟。使用Kodex-EPD完成完整的左心房成像的中位时间为7.1 [5.7；8.3] 分钟。中位RF消融时间为45.1 [34.6；58.7] 分钟。未观察到重大并发症。
由Kodex-EPD指导的RF消融PVI似乎安全可行。该系统为PVI提供了有效的三维指导。
