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不同类型多极标测导管对房颤肺静脉隔离术患者手术结局的影响

The Influence of Different Multipolar Mapping Catheter Types on Procedural Outcomes in Patients Undergoing Pulmonary Vein Isolation for Atrial Fibrillation.

作者信息

Janosi Kristof-Ferenc, Debreceni Dorottya, Bocz Botond, Torma Dalma, Keseru Mark, Simor Tamas, Kupo Peter

机构信息

Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary.

出版信息

J Clin Med. 2024 Feb 11;13(4):1029. doi: 10.3390/jcm13041029.

Abstract

(1) Background: During pulmonary vein isolation (PVI) for atrial fibrillation (AF), multipolar mapping catheters (MMC) are often used. We aimed to compare the procedural outcomes of two MMCs, specifically a circular-shaped and a five-spline-shaped MMC. (2) Methods: We enrolled 70 consecutive patients in our prospective, observational trial undergoing PVI procedures for paroxysmal AF. The initial 35 patients underwent PVI procedures with circular-shaped MMC guidance (Lasso Group), and the procedures for the latter 35 cases were performed using five-spline-shaped MMC (PentaRay Group). (3) Results: No significant differences were identified between the two groups in total procedure time (80.2 ± 17.7 min vs. 75.7 ± 14.8 min, = 0.13), time from femoral vein puncture to the initiation of the mapping (31.2 ± 7 min vs. 28.9 ± 6.8, = 0.80), mapping time (8 (6; 13) min vs. 9 (6.5; 10.5) min, = 0.73), duration between the first and last ablation (32 (30; 36) min vs. 33 (26; 40) min, = 0.52), validation time (3 (2; 4) min vs. 3 (1; 5) min, = 0.46), first pass success rates (89% vs. 91%, = 0.71), left atrial dwelling time (46 (37; 53) min vs. 45 (36.5; 53) min, = 0.56), fluoroscopy data (time: 150 ± 71 s vs. 143 ± 56 s, = 0.14; dose: 6.7 ± 4 mGy vs. 7.4 ± 4.4 mGy, = 0.90), total ablation time (1187 (1063; 1534) s vs. 1150.5 (1053; 1393.5) s, = 0.49), the number of ablations (78 (73; 93) vs. 83 (71.3; 92.8), = 0.60), and total ablation energy (52,300 (47,265; 66,804) J vs. 49,666 (46,395; 56,502) J, = 0.35). (4) Conclusions: This study finds comparable procedural outcomes bet-ween circular-shaped and five-spline-shaped MMCs for PVI in paroxysmal AF, supporting their interchangeability in clinical practice for anatomical mapping.

摘要

(1) 背景:在心房颤动(AF)的肺静脉隔离(PVI)过程中,常使用多极标测导管(MMC)。我们旨在比较两种MMC的手术结果,特别是圆形和五瓣形MMC。(2) 方法:我们纳入了70例连续接受阵发性AF的PVI手术的患者,进行前瞻性观察性试验。最初的35例患者在圆形MMC引导下进行PVI手术(Lasso组),后35例患者的手术使用五瓣形MMC(PentaRay组)。(3) 结果:两组在总手术时间(80.2±17.7分钟对75.7±14.8分钟,P = 0.13)、从股静脉穿刺到开始标测的时间(31.2±7分钟对28.9±6.8分钟,P = 0.80)、标测时间(8(6;13)分钟对9(6.5;10.5)分钟,P = 0.73)、首次消融与最后一次消融之间的持续时间(32(30;36)分钟对33(26;40)分钟,P = 0.52)、验证时间(3(2;4)分钟对3(1;5)分钟,P = 0.46)、首次通过成功率(89%对91%,P = 0.71)、左心房停留时间(46(37;53)分钟对45(36.5;53)分钟,P = 0.56)、透视数据(时间:150±71秒对143±56秒,P = 0.14;剂量:6.7±4 mGy对7.4±4.4 mGy,P = 0.90)总消融时间(1187(1063;1534)秒对1150.5(1053;1393.5)秒,P = 0.49)、消融次数(78(73;93)对83(71.3;92.8),P = 0.60)和总消融能量(52300(47265;66804)焦耳对49666(46395;

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3304/10889293/715ad065183a/jcm-13-01029-g001.jpg

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