[1]肖 源,詹碧鸣,陈杰龙,等.压力感知导管行环肺静脉电隔离术治疗阵发性心房颤动13例 [J].介入放射学杂志,2018,27(06):564-568.
 XIAO Yuan,ZHAN Biming,CHEN Jielong,et al.Circumferential pulmonary vein isolation with contact force sensing catheter for the treatment of paroxysmal auricular fibrillation: preliminary results in 13 patients[J].journal interventional radiology,2018,27(06):564-568.
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压力感知导管行环肺静脉电隔离术治疗阵发性心房颤动13例
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
27
期数:
2018年06期
页码:
564-568
栏目:
临床研究
出版日期:
2018-06-25

文章信息/Info

Title:
Circumferential pulmonary vein isolation with contact force sensing catheter for the treatment of paroxysmal auricular fibrillation: preliminary results in 13 patients
作者:
肖 源 詹碧鸣 陈杰龙 程晓曙 胡建新
Author(s):
XIAO Yuan ZHAN Biming CHEN Jielong CHENG Xiaoshu HU Jianxin
Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province 330008, China
关键词:
【关键词】 阵发性心房颤动 压力感知导管 环肺静脉电隔离
文献标志码:
A
摘要:
【摘要】 目的 探讨压力感知导管行环肺静脉电隔离(CPVI)术治疗阵发性心房颤动(AF)的安全性和有效性。方法 选取2015年8月至2016年4月首次接受CPVI术治疗的阵发性AF患者13例,其中男7例,女6例,年龄平均(63.1±7.0)岁,术中均采用压力感知导管并记录相关数据。术后3、6、9、12个月随访,收集心电图/24 h动态心电图及电话传输心电图监测(TTM)仪检测数据,了解AF复发情况。结果术中发生心脏压塞1例,予心包穿刺及外科开胸探查止血术;其余12例CPVI术均获成功,无并发症发生。1例随访9个月时TTM提示AF,1例随访6个月时动态心电图提示短阵房性心动过速(房速),3例随访9个月时动态心电图提示短阵房速,但上述患者均无胸闷、心悸等不适。结论 采用压力感知导管行CPVI治疗药物难治性阵发性AF安全有效,但远期疗效及预后尚需多中心、大样本研究随访观察。

参考文献/References:

[1] Wilke T, Groth A, Mueller S, et al. Incidence and prevalence of atrial fibrillation: an analysis based on 8.3 million patients[J]. Europace, 2013, 15: 486-493.
[2] Benjamin EJ, Wolf PA, D’Agostino RB, et al. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study[J]. Circulation, 1998, 98: 946-952.
[3] Chugh SS, Blackshear JL, Shen WK, et al. Epidemiology and natural history of atrial fibrillation: clinical implications[J]. J Am Coll Cardiol, 2001, 37: 371-378.
[4] Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design[J]. Europace, 2012, 14: 528-606.
[5] Park CI, Lehrmann H, Keyl C, et al. Mechanisms of pulmonary vein reconnection after radiofrequency ablation of atrial fibrillation: the deterministic role of contact force and interlesion distance[J]. J Cardiovasc Electrophysiol, 2014, 25: 701-708.
[6] Wittkampf FH, Nakagawa H. RF catheter ablation: lessons on lesions[J]. Pacing Clin Electrophysiol, 2006, 29: 1285-1297.
[7] Knecht S, Reichlin T, Pavlovic N, et al. Contact force and impedance decrease during ablation depends on catheter location and orientation: insights from pulmonary vein isolation using a contact force-sensing catheter[J]. J Interv Card Electrophysiol,2015, 43: 297-306.
[8] 于宏颖, 潘震华, 李艳红, 等. 环肺静脉消融联合去迷走神经化治疗心房颤动的临床研究[J]. 介入放射学杂志, 2014, 23: 569-571.
[9] Ganesan AN, Shipp NJ, Brooks AG, et al. Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis[J]. J Am Heart Assoc, 2013, 2: e004549.
[10] Cappato R, Negroni S, Pecora D, et al. Prospective assessment of late conduction recurrence across radiofrequency lesions producing electrical disconnection at the pulmonary vein ostium in patients with atrial fibrillation[J]. Circulation, 2003, 108: 1599-1604.
[11] Yokoyama K, Nakagawa H, Shah DC, et al. Novel contact force sensor incorporated in irrigated radiofrequency ablation catheter predicts lesion size and incidence of steam pop and thrombus[J]. Circ Arrhythm Electrophysiol, 2008, 1: 354-362.
[12] Lin H, Chen YH, Hou JW, et al. Role of contact force-guided radiofrequency catheter ablation for treatment of atrial fibrillation: a systematic review and meta-analysis[J]. J Cardiovasc Electro-physiol, 2017, 28: 994-1005.
[13] Shah DC, Lambert H, Nakagawa H, et al. Area under the real-time contact force curve(force-time integral) predicts radiofrequency lesion size in an in vitro contractile model[J]. J Cardiovasc Electrophysiol, 2010, 21: 1038-1043.
[14] Haldar S, Jarman JW, Panikker S, et al. Contact force sensing technology identifies sites of inadequate contact and reduces acute pulmonary vein reconnection: a prospective case control study[J]. Int J Cardiol, 2013, 168: 1160-1166.
[15] Reddy VY, Shah D, Kautzner J, et al. The relationship between contact force and clinical outcome during radiofrequency catheter ablation of atrial fibrillation in the TOCCATA study[J]. Heart Rhythm, 2012, 9: 1789-1795.
[16] Nazeri A, Ganapathy A, Massumi A, et al. Contact-force recovery can predict cardiac perforation during radiofrequency ablation[J]. Pacing Clin Electrophysiol, 2014, 37: 1129-1132.
[17] 谭红伟, 张旭敏, 邹 誉, 等. 压力感知导管消融治疗心房颤动的效果观察[J]. 山东医药, 2016, 56: 44-46.
[18] 姚 焰. 导管消融心房颤动的新进展[J]. 中国循环杂志, 2014, 29: 661-663.
[19] Kumar S, Haqqani HM, Chan M, et al. Predictive value of impedance changes for real-time contact force measurements during catheter ablation of atrial arrhythmias in humans[J]. Heart Rhythm, 2013, 10: 962-969.
[20] Lee G, Hunter RJ, Lovell MJ, et al. Use of a contact force-sensing ablation catheter with advanced catheter location significantly reduces fluoroscopy time and radiation dose in catheter ablation of atrial fibrillation[J]. Europace, 2016, 18:211-218.
[21] Naniwadekar A, Joshi K, Greenspan A, et al. Use of the new contact force sensing ablation catheter dramatically reduces fluoroscopy time during atrial fibrillation ablation procedures[J]. Indian Pacing Electrophysiol J, 2016, 16: 83-87.
[22] Jarman JW, Panikker S, Das M, et al. Relationship between contact force sensing technology and medium-term outcome of atrial fibrillation ablation: a multicenter study of 600 patients[J]. J Cardiovasc Electrophysiol, 2015, 26: 378-384.
[23] Marijon E, Fazaa S, Narayanan K, et al. Real-time contact force sensing for pulmonary vein isolation in the setting of paroxysmal atrial fibrillation: procedural and 1-year results[J]. J Cardiovasc Electrophysiol, 2014, 25: 130-137.
[24] Qi Z, Luo X, Wu B, et al. Contact force-guided catheter ablation for the treatment of atrial fibrillation: a meta-analysis of randomized, controlled trials[J]. Braz J Med Biol Res, 2016, 49: e5127.
[25] Afzal MR, Chatta J, Samanta A, et al. Use of contact force sensing technology during radiofrequency ablation reduces recurrence of atrial fibrillation: a systematic review and meta-analysis[J]. Heart Rhythm, 2015, 12: 1990-1996.
[26] Cappato R, Calkins H, Chen S A, et al. Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation[J]. Circulation, 2005, 111: 1100-1105.
[27] Bertaglia E, Zoppo F, Tondo C, et al. Early complications of pulmonary vein catheter ablation for atrial fibrillation: a multicenter prospective registry on procedural safety[J]. Heart Rhythm, 2007, 4: 1265-1271.
[28] Bunch TJ, Asirvatham SJ, Friedman PA, et al. Outcomes after cardiac perforation during radiofrequency ablation of the atrium[J]. J Cardiovasc Electrophysiol, 2005, 16: 1172-1179.
[29] Akca F, Janse P, Theuns DA, et al. A prospective study on safety of catheter ablation procedures: contact force guided ablation could reduce the risk of cardiac perforation[J]. Int J Cardiol, 2015, 179: 441-448.

备注/Memo

备注/Memo:
(收稿日期:2017-06-27)
(本文编辑:边 佶)
更新日期/Last Update: 2018-06-11