Santer David, Gahl Brigitta, Dogan Ali, Bruehlmeier Florian, Camponovo Ulisse, Maguire Rory, Goldiger Larissa, Boss Vanessa, Weber Nicole, Schmuelling Lena, Gherca Stefan, Bremerich Jens, Cueni Nadine, Koechlin Luca, Kühne Michael, Miazza Jules, Reuthebuch Oliver, Hollinger Alexa, Siegemund Martin, Sticherling Christian, Eckstein Friedrich, Amacher Simon A
Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
Medical Faculty of the University of Basel, 4056 Basel, Switzerland.
J Clin Med. 2025 Jan 14;14(2):481. doi: 10.3390/jcm14020481.
: The present study introduces our targeted approach for concomitant surgical ablation (CSA) using non-invasive phase mapping (NIPM) and describes its effectiveness regarding freedom from atrial fibrillation (AF). : This retrospective study included cardiac surgical patients undergoing preoperative NIPM for CSA guidance. The primary outcome was freedom from AF six months after surgery. Key secondary outcomes were freedom from AF at hospital discharge and three months, frequency of biatrial ablation, feasibility and safety, the rate of CSA, complications, and levels of biomarkers. The control group consisted of patients undergoing CSA without NIPM. : Forty-four patients (Control: = 31/NIPM: = 13) were included. The NIPM group was younger (64 vs. 71 years [ = 0.044]), had a lower EuroSCORE II (2.6 vs. 3.4 [ = 0.041]), and a smaller left atrial size (46 mm vs. 54 mm [ = 0.025]). Surgery duration was longer in the NIPM group (285 vs. 230 min [ = 0.037]) with similar aortic cross-clamp times. Preoperative NIPM resulted in an effective frequency of CSA of 93%. CSA was more extensive in the NIPM group, with biatrial ablation performed in 54% vs. 26% of patients ( = 0.09). : Routine preoperative NIPM in patients with non-paroxysmal atrial fibrillation might aid in increasing the number of patients receiving concomitant surgical ablation and developing a personalized CSA approach for every patient.
本研究介绍了我们使用非侵入性相位映射（NIPM）进行同期手术消融（CSA）的靶向方法，并描述了其在预防心房颤动（AF）方面的有效性。本回顾性研究纳入了接受术前NIPM以指导CSA的心脏手术患者。主要结局是术后六个月无AF。关键次要结局包括出院时和术后三个月无AF、双心房消融频率、可行性和安全性、CSA率、并发症以及生物标志物水平。对照组由未进行NIPM而接受CSA的患者组成。纳入了44例患者（对照组：n = 31/NIPM组：n = 13）。NIPM组患者更年轻（64岁 vs. 71岁 [P = 0.044]），欧洲心脏手术风险评估系统（EuroSCORE）II较低（2.6 vs. 3.4 [P = 0.041]），左心房尺寸较小（46 mm vs. 54 mm [P = 0.025]）。NIPM组手术时间更长（285分钟 vs. 230分钟 [P = 0.037]），主动脉阻断时间相似。术前NIPM使CSA的有效频率达到93%。NIPM组的CSA范围更广，54%的患者进行了双心房消融，而对照组为26%（P = 0.09）。对于非阵发性心房颤动患者，常规术前NIPM可能有助于增加接受同期手术消融的患者数量，并为每位患者制定个性化的CSA方法。
