Abstract：
BACKGROUND: There remains an imperative need to accurately map the left atrium in the setting of atrial fibrillation. While the pulmonary vein segmental ostial isolation plays a significant role in atrial fibrillation, clinical attempts to selectively ablate near the pulmonary vein myocardial sleeves have demonstrated a higher recurrence rate of arrhythmia given less precise mapping modalities. However, novel omnipolar mapping technology coupled with Advisor™ HD Grid Mapping Catheter may provide an advantageous profile to map and selectively ablate near the myocardial sleeves.
METHODS: This retrospective cohort underwent ablation targeting the pulmonary vein myocardial sleeves with the use of omnipolar mapping technology and later wide area circumferential ablation (WACA) was performed.
RESULTS: The findings of this study demonstrated a few number of lesions were required to achieve all PVI targeting PVMS at 36 (95% CI 32-41) compared to WACA at 81 (95% CI 73-90). PVMS radiofrequency time was shorter at 314 s (95% CI 278-350 s) compared to 799 s (95% CI 692-906 s) for WACA. Mean procedure time to complete PVMS was 59 min (95% CI 53-65) and to complete WACA was 90 min (95% CI 80-100).
CONCLUSIONS: Precision ablation near PVMS coupled with omnipolar technology may provide a superior profile in reducing procedure time and number of ablative lesions compared to WACA in the setting of atrial fibrillation with possible similar results. Future investigation using randomized controlled trials can help further support these findings.
METHODS: This retrospective cohort underwent ablation targeting the pulmonary vein myocardial sleeves with the use of omnipolar mapping technology and later wide area circumferential ablation (WACA) was performed.
RESULTS: The findings of this study demonstrated a few number of lesions were required to achieve all PVI targeting PVMS at 36 (95% CI 32-41) compared to WACA at 81 (95% CI 73-90). PVMS radiofrequency time was shorter at 314 s (95% CI 278-350 s) compared to 799 s (95% CI 692-906 s) for WACA. Mean procedure time to complete PVMS was 59 min (95% CI 53-65) and to complete WACA was 90 min (95% CI 80-100).
CONCLUSIONS: Precision ablation near PVMS coupled with omnipolar technology may provide a superior profile in reducing procedure time and number of ablative lesions compared to WACA in the setting of atrial fibrillation with possible similar results. Future investigation using randomized controlled trials can help further support these findings.
摘要：
背景：在心房颤动的背景下，仍然迫切需要准确绘制左心房。虽然肺静脉节段性开口隔离在心房颤动中起重要作用，在肺静脉心肌袖附近进行选择性消融的临床尝试表明,在标测方式不精确的情况下,心律失常的复发率较高.然而,新型全极标测技术结合Advisor™HDGrid标测导管可提供有利的轮廓,以在心肌套管附近进行标测和选择性消融。
方法：该回顾性队列采用全极标测技术进行了针对肺静脉心肌袖的消融，随后进行了大面积圆周消融（WACA）。
结果：这项研究的结果表明，与81（95％CI73-90）的WACA相比，在36（95％CI32-41）时，实现所有PVI靶向PVMS需要少量病变。与WACA的799s（95％CI692-906s）相比，PVMS射频时间在314s（95％CI278-350s）时更短。完成PVMS的平均手术时间为59分钟（95％CI53-65），完成WACA的平均手术时间为90分钟（95％CI80-100）。
结论：在房颤情况下，与WACA相比，PVMS附近的精确消融结合全极技术可以在减少手术时间和消融病灶数量方面提供优越的优势，可能具有相似的结果。未来使用随机对照试验的调查可以帮助进一步支持这些发现。
方法：该回顾性队列采用全极标测技术进行了针对肺静脉心肌袖的消融，随后进行了大面积圆周消融（WACA）。
结果：这项研究的结果表明，与81（95％CI73-90）的WACA相比，在36（95％CI32-41）时，实现所有PVI靶向PVMS需要少量病变。与WACA的799s（95％CI692-906s）相比，PVMS射频时间在314s（95％CI278-350s）时更短。完成PVMS的平均手术时间为59分钟（95％CI53-65），完成WACA的平均手术时间为90分钟（95％CI80-100）。
结论：在房颤情况下，与WACA相比，PVMS附近的精确消融结合全极技术可以在减少手术时间和消融病灶数量方面提供优越的优势，可能具有相似的结果。未来使用随机对照试验的调查可以帮助进一步支持这些发现。
