圆形肺静脉隔离与单点肺静脉隔离的随机比较

Nora Al-Jefairi, Ruairidh Martin, A. Frontera, A. Denis, N. Derval, F. Sacher, S. Mahida, S. Zellerhoff, X. Pillois, M. Hocini, M. Haïssaguerre, P. Jaïs
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引用次数: 0

摘要

使用单尖端(传统)导管逐点标准消融是目前肺静脉隔离(PVI)的主要技术,但它可能具有挑战性。圆形、多电极、定位和消融导管(nMARQ)可以提供更快的PVI。方法:我们设计了一个随机比较圆形与传统PVI的主要终点重新连接:急性,在索引程序,并在3个月,在系统重复程序的时间。结果:81例随机分为圆形(nMARQ n = 38)和常规(Thermocool Navistar n = 43)的患者因阵发性心房颤动接受了PVI治疗。两组患者特征相似:nMARQ年龄61±11岁(84%为男性),TC年龄60±9岁(68%为男性)。NMARQ手术更短(RF和手术时间),急性期和3个月时RIPV重连更少(指数:1(3%)对7 (16%),p = 0.044,重连:21(18%)对36 (28%),p = 0.05)。使用环形导管消融的患者也有更短的重复手术,表明更离散的PV重新连接(nMRAQ: 142±56 vs TC: 186±76分钟,p = 0.001)。随访12个月,nMARQ组和TC组分别有77%和79%的患者出现SR (p = 0.852)。未见重大手术并发症。结论:该随机研究表明,nMARQ导管分离pv的速度提高了3倍,RF和手术时间更短。3个月时PV重新连接也较少。NMARQ似乎是安全的,没有重大的程序并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Randomized Comparison of Circular versus Single Point-By-Point Pulmonary Vein Isolation
Introduction: Point-by-point standard ablation using single-tip (conventional) catheter is the main current technique for pulmonary vein isolation (PVI) but it can be challenging. A circular, multielectrode, mapping and ablation catheter (nMARQ) may provide faster PVI. Methods: We designed a randomized comparison between circular versus conventional PVI with the primary end point of reconnection: acutely, in the index procedure, and at 3 months, at the time of a systematic repeat procedure. Results: Eighty-one patients randomized to circular (nMARQ n = 38) versus conventional (Thermocool Navistar n = 43) underwent PVI for paroxysmal atrial fibrillation. Both groups had similar characteristics: nMARQ age 61 ± 11 years (84% male) and TC age 60 ± 9 years (68% male). NMARQ procedures were shorter (RF and procedure duration), with fewer RIPV reconnections, both acutely and at 3 months (index: 1 (3%) versus 7 (16%), p = 0.044, redo: 21(18%) versus 36 (28%), p = 0.05). Patients ablated with the circular catheter also had shorter repeat procedures suggesting more discrete PV reconnections (nMRAQ: 142 ± 56 versus TC: 186 ± 76 minutes, p = 0.001). At 12 months follow up, 77% of patients in nMARQ group and 79% in TC group were in SR (p = 0.852). No major procedural complications were observed. Conclusion: This randomized study shows that nMARQ catheter is 3 times faster in isolating the PVs, with shorter RF and procedure time. It is also associated with fewer PV reconnections at 3 months. NMARQ appeared to be safe with no major procedural complications.
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