Open window mapping with extended early meets late algorithm vs. conventional mapping for accessory pathway ablation.

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Jose Luis Martínez Sande, Carlos Minguito-Carazo, Laila González Melchor, Moisés Rodríguez-Mañero, Javier García Seara, Xesus Alberte Fernández López, Rubén Bergel García, Federico García-Rodeja Arias, Jose Ramón González Juanatey
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引用次数: 0

Abstract

Background: Catheter ablation of accessory pathway is the treatment of choice for patients with symptomatic Wolff-Parkinson-White (WPW) syndrome. Accessory pathway (AP) identification relies on point-by-point mapping, raising the need for more precise and efficient methods. High-density open window mapping (OWM) combined with the extended early meets late (EEML) algorithm, utilizing 3D electroanatomic mapping systems, is a promising alternative. However, its role in clinical practice lacks comprehensive investigation, necessitating a comparison with conventional mapping.

Methods: A prospective cohort study of patients referred for AP ablation evaluated the OWM strategy, comparing it with a retrospective cohort using conventional mapping. Procedure variables, including radiofrequency (RF), fluoroscopy, mapping and procedure times along with total mapping points were compared. Long-term recurrence rates were assessed.

Results: 42 patients in the OWM group and 34 in the conventional group were included. The OWM strategy exhibited a significantly lower total mapping time (p = 0.030) despite acquiring more points (p < 0.001) than the conventional group. OWM was associated with reduced fluoroscopy time (12.0 (9.0-16) vs. 19 (11-30) minutes, p = 0.009) and RF time (p = 0.021). Long-term recurrence rates were comparable between groups (7.1% OWM vs. 17.7% conventional mapping, p = 0.284). At a median follow-up of 16.2 (4.6-39.4) months there were not significant differences in recurrence-free survival (p = 0.509).

Conclusion: OWM with the EEML algorithm is a feasible tool for precise AP location and ablation, associated with less fluoroscopy time, RF time, and total mapping time. Long-term recurrence rates were similar to conventional mapping. Prospective studies are warranted for further validation.

开放窗口映射扩展早满足晚算法与常规映射辅助通路消融。
背景:副路导管消融是有症状的WPW综合征患者的首选治疗方法。辅助路径(AP)的识别依赖于逐点映射,因此需要更精确、更有效的方法。高密度开窗映射(OWM)结合扩展的早遇见晚(EEML)算法,利用三维电解剖映射系统,是一种很有前途的替代方案。然而,其在临床实践中的作用缺乏全面的调查,需要与常规制图进行比较。方法:一项对AP消融患者的前瞻性队列研究评估了OWM策略,并将其与使用传统制图的回顾性队列研究进行了比较。程序变量,包括射频(RF)、透视、作图和作图时间以及总作图点进行比较。评估长期复发率。结果:OWM组42例,常规组34例。结论:结合EEML算法的OWM是一种可行的精确AP定位和消融工具,与更少的透视时间、射频时间和总定位时间相关。长期复发率与常规制图相似。有必要进行前瞻性研究以进一步验证。
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来源期刊
CiteScore
4.30
自引率
11.10%
发文量
320
审稿时长
4-8 weeks
期刊介绍: The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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