Hirokami Jun, Moser Fabian, Schmidt Boris, Bordignon Stefano, Tohoku Shota, Schaack David, Urbanek Lukas, Urbani Andrea, Kheir Joseph, Rillig Andreas, Reissmann Bruno, Ouyang Feifan, Rottner Laura, My Ilaria, Lemoine Marc, Metzner Andreas, Chun K J Julian
Cardioangiologisches Centrum Bethanien (CCB), Frankfurt Academy for Arrhythmias (FAFA), Abteilung fur Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany.
Department of Cardiology, University Heart and Vascular Center Hamburg-Eppendorf, Hamburg, Germany.
Heart Rhythm. 2025 Jul;22(7):e40-e50. doi: 10.1016/j.hrthm.2024.11.023. Epub 2024 Nov 19.
A novel lattice tip ablation catheter that can toggle between radiofrequency and pulsed-field energy is able to perform not only pulmonary vein isolation, but also linear lesions under general anesthesia (GA).
We aimed to evaluate the concerns associated with the use of deep sedation and the clinical data related to linear ablation.
Clinical data from two Germany high-volume atrial fibrillation (AF) centers were collected. The objectives of this study are to confirm the feasibility and safety of linear lesion ablation using the lattice tip catheter without GA. Acute procedural and short-term follow-up data were collected.
This study included 55 patients who underwent AF ablation (15 with GA vs 40 with deep sedation) including linear lesion ablation for atrial tachyarrhythmia using a lattice tip catheter. Bidirectional block of linear lesions was achieved in 21 of 21 linear lesions in the GA and in 74 of 76 (97%) linear lesions in the deep sedation group (P = 1.000) including roof line in 41 of 41 (100%), posterior wall isolation in 4 of 4 (100%), anterior mitral isthmus (MI) line in 5 of 5 (100%) vs 24 of 25 (96%), posterior MI line in 1 of 1 (100%) vs 4 of 5 (80%), cavotricuspid isthmus line in 15 of 15 (100%), and 1 left atrial appendage isolation. The overall incidence rate of complications was 1.8% (1 cardiac tamponade). There was no other procedural related complication.
This preliminary clinical study demonstrates feasibility and safety of bidirectional block of linear lesions using a lattice tip catheter under deep sedation. Need to toggle between energy sources was low.
一种新型的点阵式尖端消融导管能够在射频能量和脉冲场能量之间切换，不仅能够进行肺静脉隔离，还能在全身麻醉（GA）下进行线性消融。
我们旨在评估与深度镇静使用相关的问题以及与线性消融相关的临床数据。
收集了来自两个德国大型心房颤动（AF）中心的临床数据。本研究的目的是确认在不使用GA的情况下，使用点阵式尖端导管进行线性消融的可行性和安全性。收集了急性手术期和短期随访数据。
本研究纳入了55例行AF消融术的患者（15例接受GA，40例接受深度镇静），包括使用点阵式尖端导管进行房性快速心律失常的线性消融。GA组21条线性消融中有21条实现双向阻滞，深度镇静组76条线性消融中有74条（97%）实现双向阻滞（P = 1.000），包括41条（100%）顶线、4条（100%）后壁隔离、5条（100%）二尖瓣前峡部（MI）线（25条中有24条，96%）、1条（100%）后MI线（5条中有4条，80%）、15条（100%）腔静脉-三尖瓣峡部线以及1例左心耳隔离。并发症总发生率为1.8%（1例心脏压塞）。无其他与手术相关的并发症。
这项初步临床研究证明了在深度镇静下使用点阵式尖端导管进行线性消融双向阻滞的可行性和安全性。能量源切换需求较低。
