目的:我们旨在评估使用多电极标测导管是否可以提高室性早搏(PVC)消融的疗效。
方法:前瞻性,2018年1月至2021年6月连续接受PVC消融术的患者的多中心非随机研究.患者分为两组:使用PentaRay导管(研究组)或消融导管(对照组)进行激活图。两组均采用PMF软件。评估手术终点和1年无室性心律失常。
结果:在招募期间,136名患者(60%为男性,平均年龄55±17岁,60%左侧来源)符合纳入标准-每组68例患者。研究组患者的获得性激活点数量高7倍(768±728vs.110±79,p<0.01),较短的映射时间(28±19分钟与49±32分钟,p<0.01)和更快的手术时间(110±33分钟vs.134±50分钟,p<0.01),与对照组患者相比。虽然急性成功率没有显着差异(研究组中95.6%与对照组90.1%,p=0.49),或不良事件(研究组中4%与对照组为7%,p=0.72),研究组患者在1年时无明显室性心律失常(89.7%vs.70.6%,p=0.01)。使用PentaRay导管是成功的独立预测因子(HR=6.20[95%CI,1.08-35.47],p=0.003)。
结论:使用PentaRay导管可以改善PVC消融的结果,同时缩短手术时间。
We aim to evaluate whether the use of a multielectrode mapping catheter could lead to higher efficacy of premature ventricular contraction (PVC) ablation.
Prospective, multicenter nonrandomized
study of consecutive patients referred for PVC ablation from January 2018 to June 2021. Patients were separated into two groups: activation map performed with the PentaRay catheter (
Study group) or with the ablation catheter (Control group). PMF software was used in both groups. Procedural endpoints and 1-year freedom from ventricular arrhythmia were assessed.
During the enrollment period 136 patients (60% males, mean age of 55 ± 17 years, 60% left-sided origin) fulfilled the inclusion criteria - 68 patients in each group. Patients in the
Study Group had a sevenfold higher number of acquired activation points (768 ± 728 vs. 110 ± 79, p < 0.01), a shorter mapping time (28 ± 19 min vs. 49 ± 32 min, p < 0.01) and a quicker procedure time (110 ± 33 min vs. 134 ± 50 min, p < 0.01), compared to patients in the Control Group. While there were no significant differences in the acute success (95.6% in the
Study Group vs. 90.1% in Control group, p = 0.49), or adverse events (4% in the
Study group vs. 7% in the Control group, p = 0.72), patients in the Study group had a higher freedom from ventricular arrhythmia at 1-year (89.7% vs. 70.6%, p = 0.01). The use of the PentaRay catheter was an independent predictor of success (HR = 6.20 [95% CI, 1.08-35.47], p = 0.003).
The use of the PentaRay catheter may improve the outcome of PVC ablation while reducing procedure time.