کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2922227 | 1175838 | 2013 | 7 صفحه PDF | دانلود رایگان |

BackgroundContemporary techniques to enhance anatomical detail and catheter contact during atrial fibrillation (AF) ablation include (1) the integration of preacquired tomographic reconstructions with electroanatomical mapping (3-dimensional image integration [I-EAM]), (2) the use of steerable introducers (SIs), and (3) high-frequency jet ventilation (HFJV).ObjectiveTo prove that using these stabilizing techniques during AF ablation improves 1-year procedural outcome.MethodsWe studied 300 patients undergoing AF ablation at our institution. Patients were divided into 3 equal treatment groups (100 patients each) on the basis of the tools utilized: (1) group 1: AF ablation performed without I-EAM, SI, or HFJV; (2) group 2: AF ablation performed using I-EAM and SI, but without HFJV; and (3) group 3: AF ablation performed with I-EAM, SI, and HFJV. The primary outcome was freedom from AF 1 year after a single ablation procedure. The burden of both acute and chronic pulmonary vein reconnection was also assessed.ResultsPatients from groups 2 and 3 had significantly more nonparoxysmal AF (17% vs 30% vs 39%; P = .002), larger left atria (4.2±0.8 cm vs 4.4±0.7 cm vs 4.5±0.8 cm; P<.001), and higher body mass index (BMI; 28.5±5.8 kg/m2 vs 29.1±4.8 kg/m2 vs 31.2±5.4 kg/m2; P<.001). Despite these differences, with adoption of I-EAM, SI, and HFJV we noted a significant improvement in 1-year freedom from AF (52% vs 66% vs 74%; P = .006) as well as fewer acute (1.1±1.2 vs 0.9±1.1 vs 0.6±0.9; P = .03) and chronic (3.5±0.9 vs 3.2±0.9 vs 2.4±1.0; P = .02) pulmonary vein reconnections.ConclusionsThe incorporation of contemporary tools to enhance anatomical detail and ablation catheter stability significantly improved 1-year freedom from AF after ablation.
Journal: Heart Rhythm - Volume 10, Issue 3, March 2013, Pages 347–353