Cubberley Alexander, Ahmadian-Tehrani Amir A, Kashyap Medhansh, Pickering Taylor, Dohadwala Mustafa
Baylor Scott & White, The Heart Hospital Plano, 1820 Preston Park Blvd #1450, Plano, TX, 75093, USA.
J Interv Card Electrophysiol. 2024 Dec 5. doi: 10.1007/s10840-024-01963-z.
This retrospective study evaluated two groups: patients receiving RFA for PVI, posterior wall isolation, mitral isthmus, and coronary sinus (CS) ablation with adjunctive VOM ethanol injection (VOM/RFA ALL (N = 53)), and patients receiving PVI with PFA using pentaspline catheter followed by mitral isthmus and CS ablation with RFA (PFA PV + PW/RFA MITRAL (N = 12)). We hypothesized that PFA for pulmonary vein isolation (PVI) facilitates mitral block without adjunctive vein of Marshall (VOM) ethanol injection. Mitral block was achieved in 92.5% of VOM/RFA ALL patients and 83.3% of the PFA PV + PW/RFA MITRAL group (p = 0.31). Endocardial ablation time of the mitral isthmus and RF applications required to achieve a complete block were significantly shorter in the VOM/RFA ALL group (208 s vs 356 s, p < 0.01 and 14.5 vs 24.0, p < 0.01, respectively). Adjunctive VOM ethanol injection appears to still have a role for facilitation of mitral isthmus block in the new era of PFA.
一组是接受射频消融术（RFA）进行肺静脉隔离（PVI）、后壁隔离、二尖瓣峡部及冠状窦（CS）消融并辅助Marshall静脉（VOM）乙醇注射的患者（VOM/RFA ALL组，n = 53）；另一组是使用五爪导管行PFA进行PVI，随后用RFA进行二尖瓣峡部及CS消融的患者（PFA PV + PW/RFA MITRAL组，n = 12）。我们假设，在不辅助VOM乙醇注射的情况下，使用PFA进行肺静脉隔离（PVI）有助于实现二尖瓣阻滞。VOM/RFA ALL组患者中92.5%实现了二尖瓣阻滞，PFA PV + PW/RFA MITRAL组为83.3%（p = 0.31）。VOM/RFA ALL组实现完全阻滞所需的二尖瓣峡部心内膜消融时间和射频应用次数显著更短（分别为208秒对356秒，p < 0.01；14.5次对24.0次，p < 0.01）。在PFA新时代，辅助VOM乙醇注射似乎仍对促进二尖瓣峡部阻滞有作用。
