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目的:评估环状标测与功率比式多极射频能量释放相结合的新型多极肺静脉消融导管(PVAC),在心房颤动(房颤)消融术中应用的可行性和安全性。方法:共入选47例有症状的房颤患者,其中32例为阵发性房颤(PAF组),15例为持续性房颤(PSF组),应用PVAC进行肺静脉隔离术。结果:介入手术时间平均(126.4±29.5)min[PAF组:(123.7±15.7)min,PSF组:(132.0±36.6)min,P>0.05];X线透视时间平均(30.3±11.3)min[PAF组:(29.4±9.8)min,PSF组:(32.3±14.2)min,P>0.05];PVAC消融时间平均(21.6±7.7)min[PAF组:(20.5±6.0)min,PSF组:(24.0±10.4)min,P>0.05]。在总共188支肺静脉中,有5支因其内未能检测到肺动脉电位而未实施消融术;其余183支实施消融术,其中172支(94.0%)被成功隔离。2例患者在术后第1天发现轻度的心包积液并在1周后自行吸收;所有患者均未发现肺静脉狭窄。随访(6±5)个月(3～21个月),32例(68.1%)症状明显改善或完全消失,29例(61.7%)成功维持窦性心律。结论:应用功率比式双极及单极射频能量的PVAC是一种安全可行的房颤消融新技术。
PURPOSE: To assess the feasibility and safety of a novel multi-pole pulmonary vein ablation catheter (PVAC) combining annular mapping and power-based multi-polar radiofrequency energy release in atrial fibrillation (AF) ablation. Methods: A total of 47 patients with symptomatic atrial fibrillation were enrolled. Among them, 32 patients had paroxysmal atrial fibrillation (PAF) and 15 patients had persistent atrial fibrillation (PSF). PVAC was used for pulmonary vein isolation. Results: The mean time of interventional operation was (126.4 ± 29.5) min [(123.7 ± 15.7) min in PAF group, (132.0 ± 36.6) min in PSF group, P> 0.05) PAF group: (29.4 ± 9.8) min, PSF group: (32.3 ± 14.2) min, P> 0.05]; PVAC ablation time was (21.6 ± 7.7) 24.0 ± 10.4) min, P> 0.05]. Of a total of 188 pulmonary veins, 5 failed ablation due to failure to detect pulmonary artery potential; the remaining 183 patients underwent ablation, of which 172 (94.0%) were successfully isolated. Two patients found mild pericardial effusion on the first postoperative day and self-absorbed one week later; no pulmonary stenosis was found in all patients. Follow-up (6 ± 5) months (3 ~ 21 months), 32 cases (68.1%) significantly improved or disappeared completely, and 29 cases (61.7%) successfully maintained sinus rhythm. Conclusion: PVAC with power ratio bipolar and unipolar radiofrequency is a safe and feasible new technique for AF ablation.