Catheter ablation for the treatment of atrial fibrillation （AF） has been a focal target ofelectrophysiological study in recent years. Up to date, circumferential pulmonary vein ablation （CPVA） guided by three-dime...Catheter ablation for the treatment of atrial fibrillation （AF） has been a focal target ofelectrophysiological study in recent years. Up to date, circumferential pulmonary vein ablation （CPVA） guided by three-dimensional （3-D） electreanatomic mapping （Carto, USA） has been one of the most favourable procedures for the treatment of AF. However, it is still difficult to acquire the detailed information on number, location, and branching pattern of all pulmonary veins （PVs） when the 3-D electroanatomic mapping system is used alone.展开更多
Background CartoMerge has been widely used in guiding circumferential pulmonary vein isolation （CPVI） for the treatment of paroxysmal atrial fibrillation （PAF）. However, the procedure of landmarks selection varies...Background CartoMerge has been widely used in guiding circumferential pulmonary vein isolation （CPVI） for the treatment of paroxysmal atrial fibrillation （PAF）. However, the procedure of landmarks selection varies among operators according to their experience. Techniques have to be established to standardize this procedure. We propose that Overlay Ref could facilitate this procedure. This paper aimed to report our initial experience with CPVI guided by Overlay Ref and CartoMerge for the treatment of PAF. Methods Fifty-nine patients with PAF were enrolled in this study. Using Overlay Ref technique, a reference image （inverted） was faded into the live fluoroscopic image. Landmarks of CartoMerge were selected from anatomic points of the top of superior pulmonary veins （PVs） and the bottom of inferior PVs guided by Overlay Ref image. Overlay Ref images were also used to guide the ablation procedure combining with CartoMerge. Results All patients were successfully mapped by CartoMerge guided by Overlay Ref. The distance between the mapping points and the CT surfaces was （1.42±0.67） mm for the patients as a whole. This led to a successful rate of 96% for isolation of pulmonary veins. Duration of ablation procedure was （92±17） minutes. And the total duration of procedure was （139±32） minutes. CartoMerge could also be performed just with 3 paries to 4 paries selected landmarks guided by Overlay Ref without a full anatomic model constructed by Carto. Then, the total duration of procedure could be shortened to （115±38） minutes. Conclusions Overlay Ref technique can facilitate the catheter ablation of PAF and can help to standardize the procedure of landmarks selection.展开更多
目的EASTAR（ElectroAnatomic SoluTion for All Arrhythmias）是指利用三维电解剖标测（EAM）系统处理所有快速性心律失常的治疗理念。本研究通过回顾性分析，探讨利用三维EAM系统指导各种快速性心律失常导管消融治疗的可行性。方法研...目的EASTAR（ElectroAnatomic SoluTion for All Arrhythmias）是指利用三维电解剖标测（EAM）系统处理所有快速性心律失常的治疗理念。本研究通过回顾性分析，探讨利用三维EAM系统指导各种快速性心律失常导管消融治疗的可行性。方法研究入选2009年1月至2014年12月在宁波市第一医院心律失常诊疗中心连续收治、接受射频导管消融治疗的快速性心律失常。包括心房颤动（AF）、心房扑动（AFL）、其他房性心律失常（AA）、房室结折返性心动过速（AVNRT）、房室折返性心动过速（AVRT）、室性心律失常（VA）患者共2666例，回顾性分析各类心律失常的年手术时间、X线曝光时间及曝光量的差异，并与非EASTAR方案的术者病例相比较。同时通过单个术者6年间的数据变化反映EASTAR方案下的学习曲线。结果EASTAR理念下各类心律失常导管消融手术中，三维导航系统的使用比例逐年上升，并可实现全三维化。不同基质的心律失常病例年均手术时间、X线暴露时间、X线剂量均呈显著下降趋势。与传统X线指导标测及消融的非EASTAR病例比较，全三维导管消融可显著减少手术时间及X线暴露。EASTAR理念还可优化“学习曲线”，利于术者培养。结论既往6年数据显示，EASTAR理念下全三维心律失常导管消融治疗可优化手术时间，减少射线暴露，并有利于术者培养。展开更多
Background Linear ablation of left atrium （LA） guided by three dimensional （3-D） electroanatomical mapping （Carto） has been used in many centres worldwide for the treatment of atrial fibrillation （AF） instead ...Background Linear ablation of left atrium （LA） guided by three dimensional （3-D） electroanatomical mapping （Carto） has been used in many centres worldwide for the treatment of atrial fibrillation （AF） instead of pure anatomical approaches. There were little data about linear ablation of LA guided by Carto and double Lasso catheters in China. We report the results of linear ablation of LA guided by both Carto and double Lasso catheters. Methods After the anatomical model of LA and all pulmonary veins （PVs） had been established, circumferential ablations of the left pulmonary vein antrum and the right pulmonary vein antrum were performed with 2 circumferential mapping catheters （Lasso） placed within the ipsilateral superior and inferior PVs. The endpoint of ablation was abolishment or dissociation of the pulmonary vein potentials （PVPs）. Oral amiodarone or propafenone was taken for at least 3 months by patients with persistent AF, permanent AF or those whose PVPs had not been isolated completely. The recurrence of atrial tachyarrhythmias was observed 3 months after the procedure. Results There were 106 patients （mean age, 51.4±9.9 years）. Seventy-eight patients had paroxysmal AF, 12 persistent AF and 16 permanent AF. Onset of atrial fibrillation occurred in 52 patients during ablation procedure. Thirty-two patients restored to sinus rhythm eventually after the procedure. Abolishment or dissociation of PVPs was accomplished during the procedure in 94 patients （88.7%）. The duration of procedure and exposure to X-ray were （213±45） minutes and （32.5± 12.8） minutes, respectively. Among the 87 patients followed up for over 3 months, 62 were free of atrial tachyarrhythmias （including 8 patients who were still taking oral amiodarone）. The success rate was 71.3% in the first procedure. Two patients had pericardial effusion treated by pericardial puncture and effusion drainage. No pulmonary vein stenosis, atrioesophageal fistula, stroke or procedural death occurred. Conclusi展开更多
文摘Catheter ablation for the treatment of atrial fibrillation （AF） has been a focal target ofelectrophysiological study in recent years. Up to date, circumferential pulmonary vein ablation （CPVA） guided by three-dimensional （3-D） electreanatomic mapping （Carto, USA） has been one of the most favourable procedures for the treatment of AF. However, it is still difficult to acquire the detailed information on number, location, and branching pattern of all pulmonary veins （PVs） when the 3-D electroanatomic mapping system is used alone.
文摘Background CartoMerge has been widely used in guiding circumferential pulmonary vein isolation （CPVI） for the treatment of paroxysmal atrial fibrillation （PAF）. However, the procedure of landmarks selection varies among operators according to their experience. Techniques have to be established to standardize this procedure. We propose that Overlay Ref could facilitate this procedure. This paper aimed to report our initial experience with CPVI guided by Overlay Ref and CartoMerge for the treatment of PAF. Methods Fifty-nine patients with PAF were enrolled in this study. Using Overlay Ref technique, a reference image （inverted） was faded into the live fluoroscopic image. Landmarks of CartoMerge were selected from anatomic points of the top of superior pulmonary veins （PVs） and the bottom of inferior PVs guided by Overlay Ref image. Overlay Ref images were also used to guide the ablation procedure combining with CartoMerge. Results All patients were successfully mapped by CartoMerge guided by Overlay Ref. The distance between the mapping points and the CT surfaces was （1.42±0.67） mm for the patients as a whole. This led to a successful rate of 96% for isolation of pulmonary veins. Duration of ablation procedure was （92±17） minutes. And the total duration of procedure was （139±32） minutes. CartoMerge could also be performed just with 3 paries to 4 paries selected landmarks guided by Overlay Ref without a full anatomic model constructed by Carto. Then, the total duration of procedure could be shortened to （115±38） minutes. Conclusions Overlay Ref technique can facilitate the catheter ablation of PAF and can help to standardize the procedure of landmarks selection.
文摘目的EASTAR（ElectroAnatomic SoluTion for All Arrhythmias）是指利用三维电解剖标测（EAM）系统处理所有快速性心律失常的治疗理念。本研究通过回顾性分析，探讨利用三维EAM系统指导各种快速性心律失常导管消融治疗的可行性。方法研究入选2009年1月至2014年12月在宁波市第一医院心律失常诊疗中心连续收治、接受射频导管消融治疗的快速性心律失常。包括心房颤动（AF）、心房扑动（AFL）、其他房性心律失常（AA）、房室结折返性心动过速（AVNRT）、房室折返性心动过速（AVRT）、室性心律失常（VA）患者共2666例，回顾性分析各类心律失常的年手术时间、X线曝光时间及曝光量的差异，并与非EASTAR方案的术者病例相比较。同时通过单个术者6年间的数据变化反映EASTAR方案下的学习曲线。结果EASTAR理念下各类心律失常导管消融手术中，三维导航系统的使用比例逐年上升，并可实现全三维化。不同基质的心律失常病例年均手术时间、X线暴露时间、X线剂量均呈显著下降趋势。与传统X线指导标测及消融的非EASTAR病例比较，全三维导管消融可显著减少手术时间及X线暴露。EASTAR理念还可优化“学习曲线”，利于术者培养。结论既往6年数据显示，EASTAR理念下全三维心律失常导管消融治疗可优化手术时间，减少射线暴露，并有利于术者培养。
文摘Background Linear ablation of left atrium （LA） guided by three dimensional （3-D） electroanatomical mapping （Carto） has been used in many centres worldwide for the treatment of atrial fibrillation （AF） instead of pure anatomical approaches. There were little data about linear ablation of LA guided by Carto and double Lasso catheters in China. We report the results of linear ablation of LA guided by both Carto and double Lasso catheters. Methods After the anatomical model of LA and all pulmonary veins （PVs） had been established, circumferential ablations of the left pulmonary vein antrum and the right pulmonary vein antrum were performed with 2 circumferential mapping catheters （Lasso） placed within the ipsilateral superior and inferior PVs. The endpoint of ablation was abolishment or dissociation of the pulmonary vein potentials （PVPs）. Oral amiodarone or propafenone was taken for at least 3 months by patients with persistent AF, permanent AF or those whose PVPs had not been isolated completely. The recurrence of atrial tachyarrhythmias was observed 3 months after the procedure. Results There were 106 patients （mean age, 51.4±9.9 years）. Seventy-eight patients had paroxysmal AF, 12 persistent AF and 16 permanent AF. Onset of atrial fibrillation occurred in 52 patients during ablation procedure. Thirty-two patients restored to sinus rhythm eventually after the procedure. Abolishment or dissociation of PVPs was accomplished during the procedure in 94 patients （88.7%）. The duration of procedure and exposure to X-ray were （213±45） minutes and （32.5± 12.8） minutes, respectively. Among the 87 patients followed up for over 3 months, 62 were free of atrial tachyarrhythmias （including 8 patients who were still taking oral amiodarone）. The success rate was 71.3% in the first procedure. Two patients had pericardial effusion treated by pericardial puncture and effusion drainage. No pulmonary vein stenosis, atrioesophageal fistula, stroke or procedural death occurred. Conclusi
