■导管消融术是目前心房颤动(AF)的治疗方法。然而,其对长期持续性房颤的疗效仍不理想。
■这项研究的目的是检验以下假设:全景制图系统(CARTOFINDER,BiosenseWebster)可以指导肺静脉(PV)隔离和其他潜在的AF驱动器。
■前瞻性纳入76例非阵发性房颤患者,这些患者在采用CARTOFINDER的新型高密度全景标测系统的指导下进行消融。在这个队列中,40例患者(52.6%)患有长期持续性房颤(CARTOFINDER组)。然后,我们回顾性筛选了长期持续性房颤患者,在当代期间接受常规PV隔离和消除非PV触发因素(常规组)。他们以1:2的比例进行匹配(第1组40例患者接受了由CARTOFINDER指导的消融;第2组80例患者接受了常规PV隔离和消除非PV触发因素)。
■随访期间,第1组患者房颤复发率低于第2组(P=0.040).房扑(P=0.996)和房性心动过速(P=0.525)的复发没有差异。在Cox比例风险回归分析中,房颤持续时间和肺静脉隔离以及使用CARTOFINDER全景标测系统进行房颤驱动消融都是长期持续性房颤导管消融后复发房颤的独立预测因子。
■识别长期AF中的潜在驱动因素至关重要。与传统的PV隔离和消除非PV触发相比,高密度全景标测系统(CARTOFINDER)引导下的消融对于长期持续性房颤患者可能有更好的结局.
UNASSIGNED: Catheter ablation is a current therapeutic approach for atrial fibrillation (AF). However, its efficacy for long-standing persistent AF remains suboptimal.
UNASSIGNED: The purpose of this study was to test the hypothesis that a panoramic mapping system (
CARTOFINDER, Biosense Webster) can guide pulmonary vein (PV) isolation and additional potential AF drivers.
UNASSIGNED: A total of 76 patients with nonparoxysmal AF referred for ablation guided by a novel high-density panoramic mapping system with
CARTOFINDER were prospectively enrolled. Of this cohort, 40 patients (52.6%) had long-standing persistent AF (
CARTOFINDER group). We then retrospectively screened the patients with long-standing persistent AF undergoing conventional PV isolation and elimination of non-PV triggers during the contemporary period (conventional group). They were matched at a 1:2 ratio (40 patients in group 1 received ablation guided by
CARTOFINDER; 80 patients in group 2 receiving conventional PV isolation and elimination of non-PV triggers).
UNASSIGNED: During follow-up, patients in group 1 had a lower recurrence AF rate than those in group 2 (P = .040). There was no difference in recurrence of atrial flutter (P = .996) and atrial tachycardia (P = .525). In Cox proportional hazards regression analysis, AF duration and PV isolation along with AF driver ablation using a panoramic mapping system with CARTOFINDER both were independent predictors of recurrent AF after catheter ablation of long-standing persistent AF.
UNASSIGNED: Identification of the potential drivers in long-standing AF is crucial. Compared with conventional PV isolation and elimination of non-PV triggers, ablation guided by a high-density panoramic mapping system (
CARTOFINDER) might have a better outcome in patients with long-standing persistent AF.