消融指数在射频消融治疗阵发性心房颤动中的作用研究

陈丽竹; 梁拓; 陈小璐; 张鹤萍

doi:10.13201/j.issn.1001-1439.2021.03.015

消融指数在射频消融治疗阵发性心房颤动中的作用研究

- 1. 首都医科大学附属北京友谊医院心内科(北京, 100050);
- 2. 四川大学华西第二医院儿科

详细信息

通讯作者: 张鹤萍,E-mail:cqs1950@163.com

中图分类号: R541.7

收稿日期: 2020-08-05

The role of ablation index in paroxysmal atrial fibrillation catheter ablation

- 1. Department of Cardiology, Beijing Friendship Hospital Affiliated to the Capital University of Medical Sciences, Beijing, 100050, China;
- 2. Department of Pediatrics, West China Second University Hospital

More Information

Corresponding author: ZHANG Heping, E-mail: cqs1950@163.com

Received Date: 05 August 2020

摘要

摘要: 目的:探讨消融指数(AI)指导心房颤动(房颤)射频消融的有效性和安全性。方法:选取2018年4月—2019年4月在我院心脏中心首次接受射频消融环肺静脉电隔离术(PVI)的阵发性房颤患者105例,分为AI组(AI指导PVI,52例)和CF组(传导压力导管指导PVI,53例),比较两组单圈PVI成功率、双侧PVI成功率、消融时间、总手术时间、主要手术并发症及术后随访12个月房颤复发率。结果:与CF组相比,AI组单圈PVI成功率明显提高,消融时间、总手术时间缩短,房颤复发率明显降低(P<0.05)。结论:AI指导房颤射频消融安全可行,PVI成功率高,并发症少,术后房颤复发率低。
- 心房颤动 /
- 导管消融 /
- 消融指数
Abstract: Objective: To investigate the safety and efficacy of atrial fibrillation(AF) ablation guided by the ablation index(AI).Methods: A total of 105 consecutive patients referred for paroxysmal AF underwent pulmonary vein isolation(PVI) using radiofrequency catheter ablation first time were included. Patients were divided into two groups: AI-group(AI guided ablation, n=52), CF-group(contact force guided ablation, n=53). First-pass PVI, bilateral PVI success rate, ablation time, total operation time, major complications, and 12-months follow-up AF recurrence were compared between the two groups.Results: Compared with CF-group, first-pass PVI was more frequent, mean ablation time and total operation time were shorter, and AF recurrence was significantly lower in AI-group(all P<0.05).Conclusion: Radiofrequency catheter ablation guided by AI results feasible, achieves a high rate of PVI, with a low complication rate and AF recurrence.
- atrial fibrillation /
- catheter ablation /
- ablation index

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参考文献(14)

[1]	张晶,郝应禄,李燕萍,等.STSF导管结合消融指数在阵发性心房颤动射频消融术中的应用[J].临床心血管病杂志,2020,36(5):468-471.
[2]	Ugowe FE,Jackson LR 2nd,Thomas KL.Atrial fibrillation and diabetes mellitus:can we modify stroke risk through glycemic control?[J].Circ Arrhythm Electrophysiol,2019,12(5):e007351.
[3]	Kirchhof P,Benussi S,Kotecha P,et al.2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS[J].Rev Esp Cardiol(Engl Ed),2017,70(11):1031.
[4]	Hussein A,Das M,Chaturvedi V,et al.Prospective use of ablation index targets improves clinical outcomes following ablation for atrial fibrillation[J].J Cardiovasc Electrophysiol,2017,28(9):1037-1047.
[5]	Ha AC,Wijeysundera HC,Birnie DH,et al.Real-world outcomes,complications,and cost of catheter-based ablation for atrial fibrillation:an update[J].Curr Opin Cardiol,2017,32(1):47-52.
[6]	Hussein A,Das M,Riva S,et al.Use of ablation index-guided ablation results in high rates of durable pulmonary vein isolation and freedom from arrhythmia in persistent atrial fibrillation patients:The PRAISE study results[J].Circ Arrhythm Electrophysiol,2018,11(9):e006576.
[7]	Lee SR,Choi EK,Lee EJ,et al.Efficacy of the optimal ablation index-targeted strategy for pulmonary vein isolation in patients with atrial fibrillation:the OPTIMUM study results[J].J Interv Card Electrophysiol,2019,55(2):171-181.
[8]	Phlips T,Taghji P,El Haddad M,et al.Improving procedural and one-year outcome after contact force-guided pulmonary vein isolation:the role of interlesion distance,ablation index,and contact force variability in the 'CLOSE'-protocol[J].Europace,2018,20(FI_3):f419-f427.
[9]	Kautzner J,Neuzil P,Lambert H,et al.EFFICAS II:optimization of catheter contact force improves outcome of pulmonary vein isolation for paroxysmal atrial fibrillation[J].Europace,2015,17(8):1229-1235.
[10]	Das M,Loveday JJ,Wynn GJ,et al.Ablation index,a novel marker of ablation lesion quality:prediction of pulmonary vein reconnection at repeat electrophysiology study and regional differences in target values[J].Europace,2017,19(5):775-783.
[11]	Münkler P,Kroger S,Liosis S,et al.Ablation index for catheter ablation of atrial fibrillation-linical applicability and comparison with force-time integral[J].Circ J,2018,82(11):2722-2727.
[12]	Taghji P,El Haddad M,Phlips T,et al.Evaluation of a strategy aiming to enclose the pulmonary veins with contiguous and optimized radiofrequency lesions in paroxysmal atrial fibrillation:a Pilot study[J].JACC Clin Electrophysiol,2018,4(1):99-108.
[13]	Solimene F,Schillaci V,Shopova G,et al.Safety and efficacy of atrial fibrillation ablation guided by Ablation Index module[J].J Interv Card Electrophysiol,2019,54(1):9-15.
[14]	Dhillon G,Ahsan S,Honarbakhsh S,et al.A multicentered evaluation of ablation at higher power guided by ablation index:Establishing ablation targets for pulmonary vein isolation[J].J Cardiovasc Electrophysiol,2019,30:357-365.