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电子流量绘制导向导管切除对持久性心房的患者提供了优势

Rita B Gagyi¹, Rohit E Bhagwandien¹, Sing-Chien Yap¹

¹Department of Clinical Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands.

Pacing and clinical electrophysiology : PACE

|June 1, 2023

概括

与标准方法相比,电物理流 (EGF) 引导导管切除 (CA) 显著减少心房 (AF) 的复发. 这种有针对性的方法为持久性AF患者提供了更安全,更有效的策略.

科学领域:

心脏病学心脏病学
电子生理学电子生理学
医疗技术医疗技术医学技术

背景情况:

对于持续性心房动 (AF) 的导管切除 (CA) 面临着挑战,成功率低于最佳.
当前的映射技术在持续的情况下难以可靠地识别AF源.
电图流量 (EGF) 映射系统,利用光学流量算法,量化心房电波面传播.

研究的目的:

评估以EGF映射为指导的目标源废除是否比实证AF废除改善了结果.
为了比较EGF引导CA的疗效和安全性与传统的废除技术.

主要方法:

一项涉及因持续性AF而接受EGF导向切除的患者的研究.
与PVI+EGF指导CA的PVI+EGF指导CA和PVI+实证线性/基板剥离 (PVI+LINES) 组的PVI+EGF指导CA的比较.
分析12个月内没有AF/心房动心/动 (AT/AFL),程序安全和效率指标的分析.

主要成果:

在PVI+EGF组 (12个月) 中,与PVI单独 (62.5%) 和PVI+LINES (53.3%) 组 (p=0.02) 相比,在PVI+EGF组 (25.6%) 的AF复发较少.
跨组AT/AFL复发率没有显著差异.
PVI+EGF程序的持续时间较长 (p<0.01),但使用类似的光镜.

结论:

经EGF引导的CA证明了持续性AF患者的AF复发率降低.
这种方法提供了一个安全的,有针对性的,患者特异的除策略,超出了标准的肺静脉隔离.
在复杂的持久性AF病例中,EGF引导的切除似乎优于经验性切除策略.

关键词:

导管切除导管切除导管切除导管切除电解剖学绘制地图电图流量映射电图流量映射持续的心房动持续的心房动肺静脉隔离肺静脉隔离肺静脉隔离三维映射绘制的三维地图.

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