METHODS: A retrospective analysis was conducted on patients who underwent pulmonary vein isolation (PVI) for PAF between August 2022 and March 2023, using high-power short-duration ablation. Thirty-five patients underwent RFCA with HFLTV ventilation and were matched with another cohort of 35 patients who underwent RFCA with SV. Parameters including ablation duration, contact force (CF), impedance drop, and ablation index were extracted from the CARTONET database for each ablation lesion.
RESULTS: A total of 70 patients were included (HFLTV = 35/2484 lesions, SV = 35/2830 lesions) in the analysis. There were no differences in baseline characteristics between the groups. While targeting the same ablation index, the HFLTV ventilation group demonstrated shorter average ablation duration per lesion (12.3 ± 5.0 vs. 15.4 ± 8.4 s, p < .001), higher average CF (17.0 ± 8.5 vs. 10.5 ± 4.6 g, p < .001), and greater impedance reduction (9.5 ± 4.6 vs. 7.7 ± 4.1 ohms, p < .001). HFLTV ventilation group also demonstrated shorter total procedural time (61.3 ± 25.5 vs. 90.8 ± 22.8 min, p < .001), ablation time (40.5 ± 18.6 vs. 65.8 ± 22.5 min, p < .001), and RF time (15.3 ± 4.8 vs. 22.9 ± 9.7 min, p < .001).
CONCLUSIONS: HFLTV ventilation during PVI for PAF was associated with improved ablation lesion parameters and procedural efficiency compared to SV.
方法:对2022年8月至2023年3月接受肺静脉隔离(PVI)治疗PAF的患者进行了回顾性分析,使用高功率短期消融。35例患者接受RFCA和HFLTV通气,并与另一个35例接受RFCA和SV的患者进行匹配。参数包括消融持续时间,接触力(CF),阻抗下降,从CARTONET数据库中提取每个消融损伤的消融指数.
结果:共纳入70例患者(HFLTV=35/2484病变,SV=35/2830病变)在分析中。两组之间的基线特征没有差异。以相同的消融指数为目标,HFLTV通气组每个病灶的平均消融时间较短(12.3±5.0vs.15.4±8.4s,p<.001),较高的平均CF(17.0±8.5与10.5±4.6g,p<.001),和更大的阻抗降低(9.5±4.6vs.7.7±4.1欧姆,p<.001)。HFLTV通气组的总手术时间也较短(61.3±25.5vs.90.8±22.8min,p<.001),消融时间(40.5±18.6vs.65.8±22.5min,p<.001),和射频时间(15.3±4.8vs.22.9±9.7分钟,p<.001)。
结论:与SV相比,在PAF的PVI期间HFLTV通气与改善消融损伤参数和手术效率相关。