背景:将乙醇输注(EI)到马歇尔静脉(VOM)(EIVOM)已作为辅助心房颤动(AF)治疗进行。然而,时间的变化,定量病变调查,和对心外膜脂肪垫的影响和由EIVOM创建的分割心房电描记图从未被研究过。
目的:本研究旨在对EIVOM产生的病变进行定量分析。
方法:我们立即使用3D绘图系统创建了电压图,30,并在进行EIVOM后60分钟研究病变的时程变化。其中,我们比较了平均接触力(CF)值的差异,这对于有和没有EIVOM的患者之间的VOM区域成功传导阻滞是必需的。我们还研究了EIVOM对EIVOM前后连续分割心房电描记图(CFAE)面积的影响。我们使用计算机断层扫描测量了EIVOM前后的心外膜脂肪垫总体积。
结果:在EIVOM之后,电压显着降低,并且在控制之间的电压降低方面存在显着差异,在EIVOM后30分钟和60分钟(p<0.05)。使用EIVOM而不是没有EIVOM的平均CF值显著较低(p<0.05)。EIVOM后心外膜脂肪总量和CFAE面积也显著下降(p<0.05)。
结论:EIVOM对维持房颤的左心房组织提供了显著的治疗效果,通过定量分析证明了这一点。
BACKGROUND: Ethanol infusion (EI) into the vein of Marshall (VOM) (EIVOM) has been performed as an adjunctive atrial fibrillation (AF) therapy. However, the time course change, quantitative lesion investigation, and effects on the epicardial fat pads and fractionated atrial electrograms created by the EIVOM have never been investigated.
OBJECTIVE: This study aimed to perform a quantitative analysis of lesions created by the EIVOM.
METHODS: We created voltage maps using a 3D mapping system immediately, 30 , and 60 minutes after performing the EIVOM to study the time course change in the lesions. Among them, we compared the differences in the average contact force (CF) value, which was required for successful conduction block in the VOM area between patients with and without EIVOM. We also investigated the effects of the EIVOM on the area of continuous fractionated atrial electrograms (CFAE) before and post-EIVOM. We measured the total epicardial fat pad volume before and after the EIVOM using computed tomography.
RESULTS: The voltage was significantly reduced after the EIVOM, and there were significant differences regarding the voltage reduction among the control, 30 minutes and 60 minutes after the EIVOM (p<0.05). The average CF value was significantly lower with rather than without an EIVOM (p<0.05). The total epicardial fat volume and CFAE area also significantly decreased after the EIVOM (p<0.05).
CONCLUSIONS: The EIVOM provided significant therapeutic effects on the left atrial tissue perpetuating AF, which was demonstrated by a quantitative analysis.