Li Jian, Hua Yu, Qiao Lei, Wang Bo, Pang Xuefeng, Jia He, Yu Yang, Yu Bo, Sun Yingxian, Zhang Xingang, Chen Yanli
Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China.
Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110032, Liaoning Province, China.
J Transl Int Med. 2022 Aug 31;10(3):264-271. doi: 10.2478/jtim-2022-0040. eCollection 2022 Sep.
A novel wide-band dielectric mapping system, named as KODEX-EPD (EPD Solutions, Philips, Best, the Netherlands), was effectively used in the EA mapping for atrial fibrillation (AF) ablation. To date, only a few studies have concentrated on the application of the KODEX-EPD system for ablating supraventricular tachycardia or ventricular premature beats (VPBs) in human models. This study aims to assess the applicability and efficiency of a novel three-dimensional electro-anatomic (EA) mapping system to improve the success rate of ablation.
This study included 11 consecutive patients who underwent ablation after EA mapping with the KODEX-EPD system.
All surgeries were successfully performed using the KODEX-EPD system, including 6 cases who underwent ablation of paroxysmal supraventricular tachycardia (PSVT), 2 cases who received ablation of VPBs from right ventricular outflow tract (RVOT), and 3 cases who underwent cryoablation of AF. For ablation of PSVT or VPBs, the operation time was 31.4 (range, 24.0-38.0) min, in which a median operation time of 2.9 min was used to create anatomic images, and the median fluoroscopic dose was 7.4 mGy. For ablation of AF, the operation time was 56.0 (range, 49.0-62.0) min, in which a median of 4.3 (range, 3.4-5.2) min was used for constructing left atrium map, and the median fluoroscopic dose was 15.0 mGy. The operation time and the fluoroscopic dose were greatly shortened for all surgeries.
The KODEX-EPD system is an effective and safe tool to guide the EA mapping, leading to improvement in the success rate of ablation. It can promote the ablation process with the reduced fluoroscopic dose, and it is also a promising tool for complex surgeries.
一种名为KODEX-EPD（EPD解决方案，飞利浦公司，荷兰贝斯特）的新型宽带介电标测系统已有效地用于心房颤动（AF）消融的电激动标测（EA）。迄今为止，仅有少数研究关注KODEX-EPD系统在人体模型中用于消融室上性心动过速或室性早搏（VPB）的应用。本研究旨在评估一种新型三维电解剖（EA）标测系统的适用性和效率，以提高消融成功率。
本研究纳入了11例连续使用KODEX-EPD系统进行EA标测后接受消融的患者。
所有手术均使用KODEX-EPD系统成功完成，其中包括6例阵发性室上性心动过速（PSVT）消融、2例右心室流出道（RVOT）室性早搏消融以及3例AF冷冻消融。对于PSVT或VPB消融，手术时间为31.4（范围24.0 - 38.0）分钟，其中用于创建解剖图像的中位手术时间为2.9分钟，中位透视剂量为7.4 mGy。对于AF消融，手术时间为56.0（范围49.0 - 62.0）分钟，其中用于构建左心房图的中位时间为4.3（范围3.4 - 5.2）分钟，中位透视剂量为15.0 mGy。所有手术的手术时间和透视剂量均大幅缩短。
KODEX-EPD系统是指导EA标测的有效且安全的工具，可提高消融成功率。它能以降低的透视剂量促进消融过程，也是复杂手术的有前景的工具。
