■本研究的目的是观察Cox-MazeIV手术后电生理标测的安全性和有效性,并研究Cox-MazeIV手术后房颤(AF)复发与双向电隔离的完整性和AF的诱导性之间是否存在相关性。
■完全,将80例主动脉瓣或二尖瓣疾病和持续性房颤的连续患者随机纳入对照组,并按照Cox-MazeIV组(电生理-迷宫组)进行电生理标测。在电生理迷宫组,患者同时接受Cox-Maze手术和二尖瓣峡部消融线的电生理标测,左心房“框,“和三尖瓣环。如果三尖瓣环消融线双向电隔离不完整,是否实施辅助消融将由操作者独立决定。在Cox-MazeIV手术前后,进行AF诱导。两组患者均连续随访,6个月后行心电图动态心电图监测。
■总共,纳入42例电生理迷宫患者和38例对照。与对照组患者相比,住院时间较短,更好的心脏重塑变化,在电生理迷宫组的6个月随访期间,房颤缓解率较高。在电生理迷宫组中,“箱”消融线的不完全双向电隔离率为零,二尖瓣峡部消融线或三尖瓣环消融线不完全双向电隔离率为23.8%。在三尖瓣环消融线上成功补充消融两例后,环消融线的最终不完全双向电隔离为19.0%。6个月后的晚期房颤复发与环消融线的不完全双向电隔离与Cox-MazeIV手术后立即诱导房颤之间存在相关性。
■Cox-Maze程序后的电生理标测是安全有效的。Cox-Maze手术中的电生理标测可以通过评估消融线双向电隔离的完整性来发现非透壁环消融线。引导辅助消融,并预测6个月后房颤复发。
UNASSIGNED: The objective of this study was to observe the safety and efficacy of electrophysiological mapping following the Cox-Maze IV procedure and to investigate whether a correlation exists between recurrence of atrial fibrillation (AF) with the completeness of bidirectional electrical isolation and the inducibility of AF immediately after the Cox-Maze IV procedure.
UNASSIGNED: Totally, 80 consecutive patients who suffered from aortic valve or mitral valve disease and persistent AF were randomly enrolled into the control group and electrophysiological mapping following the Cox-Maze IV group (Electrophysio-Maze group). In the Electrophysio-Maze group, patients underwent concomitant Cox-Maze procedure and following electrophysiological mapping of ablation lines in mitral isthmus, left atrial \"box,\" and tricuspid annulus. If the bidirectional electrical isolation of tricuspid annulus ablation line is incomplete, whether to implement supplementary ablation will be independently decided by the operator. Before and after the Cox-Maze IV procedure, AF induction was performed. All patients in both groups were continuously followed-up and underwent electrocardiogram Holter monitoring after 6 months.
UNASSIGNED: In total, 42 Electrophysio-Maze patients and 38 controls were enrolled. Compared with patients in the control group, there were shorter hospital stay, better cardiac remodeling changes, and higher relief from AF during the follow-up period of 6 months in the Electrophysio-Maze group. Within the Electrophysio-Maze group, the rate of incomplete the bidirectional electrical isolation of \"box\" ablation lines was zero, and the rate of incomplete bidirectional electrical isolation of mitral isthmus ablation line or tricuspid annulus ablation line was 23.8%. After two cases of successful complementary ablation on the tricuspid annulus ablation line, the final incomplete bidirectional electrical isolation of annulus ablation lines was 19.0%. There were correlations between late AF recurrence after 6 months with incomplete bidirectional electrical isolation of annulus ablation lines and AF induction immediately after the Cox-Maze IV procedure.
UNASSIGNED: Electrophysiological mapping following the Cox-Maze procedure is safe and effective. Electrophysiological mapping in the Cox-Maze procedure can find out the non-transmural annulus ablation lines by assessing the completeness of bidirectional electrical isolation of ablation lines, guide supplementary ablation, and predict AF recurrence after 6 months.