消融指数引导下高功率消融治疗心房颤动的安全性和有效性。
Safety and efficacy of ablation index-guided high-power ablation for the treatment of atrial fibrillation.
作者信息
Zhu Jing, Lin Xian-He
机构信息
Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province 230000, China.
Department of Cardiology, The Provincial Hospital Affiliated to Anhui Medical University, Hefei City, Anhui Province 230000, China.
出版信息
Heliyon. 2023 Apr 9;9(4):e15311. doi: 10.1016/j.heliyon.2023.e15311. eCollection 2023 Apr.
OBJECTIVE
To study the safety and efficacy of high-power ablation for atrial fibrillation (AF) guided by lesion size index (LSI) and impedance cutoff.
METHOD
A total of 223 patients who underwent radiofrequency catheter ablation of atrial fibrillation (including paroxyparal atrial fibrillation and persistent atrial fibrillation) in the Department of Cardiology of Anhui Provincial Hospital from February 2019 to July 2020 were enrolled, and were divided into 123 patients in the high-power ablation group (HPAI) and 100 patients in the conventional power ablation group (CPAI). The HPAI group adopted high-power (40-50 W) ablation by impedance cutoff, and the CPAI group adopted conventional-power (30-35 W) ablation. Patients in both groups were ablated guided by the same LSI. For both groups, we analyzed the pulmonary vein single-circle isolation rate, ablation time, X-ray exposure, impedance drop value, incidence of complications, and recurrence rate within one year after operation.
RESULTS
There was no significant difference in the success rate of pulmonary vein single-circle isolation, X-ray perspective time, and X-ray exposure quantity between the HPAI group and the CPAI group (88.60% vs 82.00%, = 0.161; 8.7 ± 3.74 min vs 7.82 ± 3.86 min, = 0.067; 54.74 ± 28 min vs 52.78 ± 39.58 min, = 0.139); the annular pulmonary vein ablation time and total ablation time were less in the HPAI group (35.74 ± 7.25 min vs 65.49 ± 7.34 min, < 0.01; 55.42 ± 11.61 min vs 76.9 ± 6.79 min, < 0.01); the impedance drop values at 10-15Ω and 15-20Ω were higher in the HPAI group (25.3% vs 19.1%, < 0.05; 24.1% vs 19.1%, < 0.05); there was no significant difference in the recurrence rate within one year after operation between the two groups; and no serious complications occurred in the two groups.
CONCLUSION
High-power ablation guided by LSI and impedance cutoff could significantly shorten the AF ablation time and reduce complications.
目的
研究基于损伤大小指数（LSI）和阻抗截断值指导下的高功率消融治疗心房颤动（AF）的安全性和有效性。
方法
选取2019年2月至2020年7月在安徽省立医院心内科接受心房颤动（包括阵发性心房颤动和持续性心房颤动）射频导管消融治疗的223例患者，分为高功率消融组（HPAI组，123例）和传统功率消融组（CPAI组，100例）。HPAI组采用基于阻抗截断值的高功率（40 - 50W）消融，CPAI组采用传统功率（30 - 35W）消融。两组患者均在相同的LSI指导下进行消融。分析两组患者的肺静脉单环隔离率、消融时间、X线曝光情况、阻抗下降值、并发症发生率及术后1年内复发率。
结果
HPAI组与CPAI组肺静脉单环隔离成功率、X线透视时间及X线曝光量差异无统计学意义（88.60%对82.00%， = 0.161；8.7 ± 3.74分钟对7.82 ± 3.86分钟， = 0.067；54.74 ± 28分钟对52.78 ± 39.58分钟， = 0.139）；HPAI组肺静脉环形消融时间及总消融时间更短（35.74 ± 7.25分钟对65.49 ± 7.34分钟， < 0.01；55.42 ± 11.61分钟对76.9 ± 6.79分钟， < 0.01）；HPAI组10 - 15Ω和15 - 20Ω时的阻抗下降值更高（25.3%对19.1%， < 0.05；24.1%对19.1%， < 0.05）；两组术后1年内复发率差异无统计学意义；两组均未发生严重并发症。
结论
基于LSI和阻抗截断值指导下的高功率消融可显著缩短房颤消融时间并减少并发症。
Zotero 插件