一种新型呼吸补偿稳定性算法在心房颤动射频消融术中的性能

Performance of a new respiratory compensated stability algorithm during radiofrequency ablation for atrial fibrillation.

作者信息

Berte Benjamin, Valeriano Chiara, Rissotto Sophie, Sigal Alona, Klemm Ofer, Mahida Saagar, De Potter Tom, Pürerfellner Helmut, Kobza Richard

机构信息

Heart Center, Hirslanden St Anna, Zentralstrasse 1, 6004, Lucerne, Switzerland.

Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.

出版信息

J Interv Card Electrophysiol. 2025 Mar 27. doi: 10.1007/s10840-025-02031-w.

DOI:10.1007/s10840-025-02031-w

PMID:40148702

Abstract

BACKGROUND

Short-duration radiofrequency ablation is designed to enhance efficiency of pulmonary vein isolation (PVI). We investigated the performance of a novel stability algorithm (STABILITY +).

METHODS

In a prospective, single-center study, consecutive patients undergoing first-time PVI were included. Patients were categorized into four groups: Group 1, Hybrid (anterior, 50 W, 550 AI; posterior, 90 W 4 s) using Viistag; Group 2, Hybrid using STABILITY + ; Group 3, 90 W (anterior and posterior, 90 W 4 s) using Visitag; Group 4, 90 W using STABILITY + . Clinical, procedural and follow-up data were systematically collected.

RESULTS

A total of 268 patients were included. In total, 130 patients had Hybrid ablation while 138 underwent 90-W ablation. Procedure time was comparable in Groups 1, 2, and 3 however was lower in Group 4 (65 min, 65 min, 70 min, 54 min, p < 0.001). RF-time was longer in Group 1 and 2 vs 3 and 4 (11.6 min, 9.7 min, 4.5 min, 5.2 min, p < 0.001). First-pass isolation rates were comparable between all 4 groups (88%, 91%, 83.9%, 90%, p = 0.480). Freedom from arrhythmia at 6 months was also comparable (9%, 9%, 16.6%, 10.4%, p = 0.341). Complications were comparable and low and restricted to vascular access-related complications (2%, 1%, 0%, 2%, p = 0.388).

CONCLUSIONS

Irrespective of the mode of ablation, the novel STABILITY + algorithm can be used in PVI ablations without compromising safety and efficiency and has the potential to improve first-pass isolation using 90-W HPSD ablation.

摘要

背景

短程射频消融旨在提高肺静脉隔离（PVI）的效率。我们研究了一种新型稳定性算法（STABILITY +）的性能。

方法

在一项前瞻性单中心研究中，纳入了连续接受首次PVI的患者。患者被分为四组：第1组，使用Viistag进行混合消融（前部，50 W，550 AI；后部，90 W，4秒）；第2组，使用STABILITY +进行混合消融；第3组，使用Visitag进行90 W消融（前部和后部，90 W，4秒）；第4组，使用STABILITY +进行90 W消融。系统收集临床、手术和随访数据。

结果

共纳入268例患者。总共有130例患者接受了混合消融，138例接受了90 W消融。第1、2和3组的手术时间相当，但第4组较低（65分钟、65分钟、70分钟、54分钟，p < 0.001）。第1组和第2组的射频时间比第3组和第4组长（11.6分钟、9.7分钟、4.5分钟、5.2分钟，p < 0.001）。所有4组的首次隔离率相当（88%、91%、83.9%、90%；p = 0.480）。6个月时无心律失常的情况也相当（9%、9%、16.6%、10.4%；p = 0.341）。并发症相当且发生率低，仅限于血管通路相关并发症（2%、1%、0%、2%；p = 0.388）。