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具有柔性尖端的首次接触力消融导管的安全性和有效性。

Safety and effectiveness of the first contact force ablation catheter with a flexible tip.

作者信息

Nair Devi, Martinek Martin, Colley B Judson, Sundaram Sri, Hariharan Ramesh, Morales Gustavo, Sommer Philipp, Healy Stewart, Siddiqui Usman, Gibson Douglas, Chapman Kristina, Sarver Anne, Lo Monica

机构信息

St. Bernard's Medical Center, Jonesboro, Arkansas.

Cardiology, Angiology, and Intensive Care Medicine, Ordensklinikum Linz Elisabethinen, Linz, Austria.

出版信息

Heart Rhythm O2. 2023 Oct 31;4(12):784-793. doi: 10.1016/j.hroo.2023.10.006. eCollection 2023 Dec.

Abstract

BACKGROUND

Catheter ablation is an established therapy for paroxysmal atrial fibrillation (PAF). The TactiFlex Ablation Catheter, Sensor Enabled (TactiFlex SE) is a next-generation radiofrequency ablation catheter incorporating fiber optics-based contact force-sensing technology with a flexible, laser-cut tip.

OBJECTIVE

The study sought to evaluate the safety and effectiveness of the TactiFlex SE ablation catheter for treatment of drug-refractory PAF.

METHODS

The TactiFlex AF investigational device exemption was a prospective, nonrandomized, multicenter clinical study. Enrollment began on June 26, 2020 and completed June 18, 2021. Subjects with PAF underwent de novo pulmonary vein isolation and, if indicated, ablation for typical atrial flutter. Subjects were followed for 12 months.

RESULTS

Of the 355 subjects enrolled at 37 sites worldwide, 334 underwent ablation with the TactiFlex SE catheter. The Kaplan-Meier estimate of 12-month freedom from AF/atrial flutter (AFL)/atrial tachycardia recurrence was 72.9% (95% confidence interval [CI] 95% CI 67.2%-77.8%) and clinical success was 83.6% (95% CI 95% CI 78.1%-87.2%). As-treated analyses compared subjects treated at high power (left atrium time-averaged power setting 40-50 W; n = 222) vs low power (<40 W; n = 97). The Kaplan-Meier estimate of 12-month freedom from AF/AFL/atrial tachycardia recurrence was 76.4% (95% CI 69.3%-82.0%) and clinical success was 83.9% (95% CI 77.5%-88.6%) in the high-power group compared with 66.8% (95% CI 56.1%-75.5%) and 80.7% (95% CI 70.8%- 87.5%), respectively, in the low-power group. The primary safety event rate in all treated subjects was 4.3%; 4.1% in the HP group and 5.2% in the LP group ( = .7671).

CONCLUSION

TactiFlex SE is safe and effective for treatment of drug-refractory PAF and concomitant AFL and enables more efficient procedures than previous generation catheters.

摘要

背景

导管消融是阵发性心房颤动(PAF)的既定治疗方法。带传感器的 TactiFlex 消融导管(TactiFlex SE)是一款下一代射频消融导管,它将基于光纤的接触力传感技术与灵活的激光切割尖端相结合。

目的

本研究旨在评估 TactiFlex SE 消融导管治疗药物难治性 PAF 的安全性和有效性。

方法

TactiFlex AF 研究性器械豁免是一项前瞻性、非随机、多中心临床研究。入组于 2020 年 6 月 26 日开始,并于 2021 年 6 月 18 日完成。PAF 患者接受了初次肺静脉隔离术,如有指征,还进行了典型心房扑动的消融。对患者进行了 12 个月的随访。

结果

在全球 37 个地点入组的 355 名受试者中,334 名接受了 TactiFlex SE 导管消融。12 个月无房颤/心房扑动(AFL)/房性心动过速复发的 Kaplan-Meier 估计值为 72.9%(95%置信区间[CI]95%CI 67.2%-77.8%),临床成功率为 83.6%(95%CI 95%CI 78.1%-87.2%)。治疗分析比较了高功率组(左心房时间平均功率设置为 40-50W;n = 222)和低功率组(<40W;n = 97)的受试者。高功率组 12 个月无房颤/AFL/房性心动过速复发的 Kaplan-Meier 估计值为 76.4%(95%CI 69.3%-82.0%),临床成功率为 83.9%(95%CI 77.5%-88.6%),而低功率组分别为 66.8%(95%CI 56.1%-75.5%)和 80.7%(95%CI 70.8%-87.5%)。所有治疗受试者的主要安全事件发生率为 4.3%;高功率组为 4.1%,低功率组为 5.2%(P = 0.7671)。

结论

TactiFlex SE 治疗药物难治性 PAF 和伴发的 AFL 安全有效,与前代导管相比,手术效率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b52e/10774658/989a09475eaa/gr1.jpg

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