成人先天性心脏病复杂心房心律失常的三维电解剖定位——单中心经验。

IF 1.3
Pacing and clinical electrophysiology : PACE Pub Date : 2025-08-01 Epub Date: 2025-07-17 DOI:10.1111/pace.70012
Nili Schamroth Pravda, Ofir Brem, Alon Barsheshet, Kirill Buturlin, Aharon Erez, Ehud Kadmon, Gustavo Goldenberg, Ran Kornowski, Rafael Hirsch, Gregory Golovchiner
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引用次数: 0

摘要

成人先天性心脏病(ACHD)患者患有多种不典型心房心律失常。三维电解剖测绘系统有助于识别和消融对这些心律失常起始至关重要的致心律失常底物。方法:我们报告了在本中心使用高密度心律失常(Boston Scientific心律失常)治疗的ACHD和心房心律失常患者。Marlborough, MA)制图系统。手术成功的定义是在手术结束时没有引起持续的心律失常。部分成功定义为临床心律失常无诱发性。结果:我们的队列包括16例患者,其中21例进行了电解剖定位和消融。患者以女性为主(13例,87%),平均年龄43.5±10.3岁。先天性心脏病的诊断多种多样,包括方坦循环和心房开关姑息治疗大动脉转位。经鉴定的心律失常包括21例房内再入性心动过速和9例局灶性心动过速。14例(66.6%)手术成功,5例(23.8%)手术部分成功,2例(9.5%)手术不成功。没有手术相关的主要不良事件的报道。平均随访15.3±12.6个月,心律失常复发4例(44%),复诊4例,停用抗心律失常药物3例(18.8%)。结论:电解剖测图对ACHD患者复杂心房心律失常的识别和治疗具有重要意义。在这个队列中,定位辅助消融治疗ACHD患者的复杂心房心律失常是安全、可行的,并且显示出可接受的成功率。摘要:ACHD患者有异常的心脏解剖和心房心律失常往往可以是不典型的。电解剖测图有助于识别和治疗ACHD患者的复杂心房心律失常。我们发现,使用高分辨率三维电解剖测绘是安全、可行和有效的治疗复杂心房心律失常的ACHD。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
3D Electroanatomical Mapping for Complex Atrial Arrhythmias in Adult Congenital Heart Disease-A Single Center Experience.

Introduction: Adult Congenital Heart Disease (ACHD) patients suffer from multiple, and often atypical, atrial arrhythmias. 3D electro-anatomical mapping systems assist in the identification and ablation of arrhythmogenic substrates critical to the initiating of theses arrhythmias.

Methods: We report on patients with ACHD and atrial arrhythmias treated at our center using the high density Rhythmia (Boston Scientific. Marlborough, MA) mapping system. Procedural success was defined as no sustained arrhythmia inducible at the end of the procedure. Partial success was defined as non-inducibility of the clinical arrhythmia.

Results: Our cohort included 16 patients in whom 21 electro-anatomical mapping and ablations were performed. Most patients were female (13 patients, 87%) and the average age was 43.5 ± 10.3 years. The congenital heart disease diagnosis was varied, including Fontan circulation and atrial switch palliation for Transposition of the great arteries. The identified arrhythmias included 21 intra-atrial re-entrant tachycardias and nine focal atrial tachycardias. In 14 cases (66.6%) the procedure was successful, in five cases (23.8%) the procedure was partially successful, and two cases (9.5%) were unsuccessful. There were no procedure-related major adverse events reported. At mean follow up of 15.3 ± 12.6 months, there were four cases of recurrent arrhythmias (44% of patients), four re-do procedures, three patients (18.8%) were discontinued from their antiarrhythmic medications.

Conclusion: Electro-anatomical mapping is useful in the identification and treatment of complex atrial arrhythmias in patients with ACHD. In this cohort, mapping-assisted ablation of complex atrial arrhythmias in patients with ACHD was safe, feasible, and demonstrated an acceptable success rate.

Condensed abstract: Patients with ACHD have anomalous cardiac anatomy and atrial arrhythmias can often be atypical. Electro-anatomical mapping is useful in the identification and treatment of complex atrial arrhythmias among patients with ACHD. We found that the use of a high-resolution 3D electro-anatomic mapping is safe, feasible and effective for the treatment of complex atrial arrhythmias in ACHD.

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