Pulmonary vein antrum isolation of pre-excited atrial fibrillation  

作　　者：FENG Xiang-fei WANG Qun-shan SUN Jian ZHANG Peng-pai WANG Jun WANG Yue-peng LIYi-gang 

机构地区：[1]Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China

出　　处：《Chinese Medical Journal》2013年第14期2613-2619,共7页中华医学杂志（英文版）

摘　　要：Background Pulmonary vein antrum isolation （PVAI） of pre-excited atrial fibrillation （AF） is controversial. This study aimed to observe the therapeutic effects of PVAI on pre-excited AF. Methods Twenty-nine patients with pre-excited AF were prospectively divided into a PVAI group （group I, 19 cases） and a control group （group II, 10 cases）. To each case in group I, PVAI was performed, and then electroanatomical mapping of accessory pathways （AP） and ablation were constructed on a three-dimensional （3D） map of the valve annulus. Only AP ablation was performed in each case of group II. Results Of the 29 cases, three were found to have dual APs, two had intermittent APs, and the remaining 24 had single APs. All APs were successfully ablated after the procedure. There were no significant statistical differences in the AP procedure duration （（77.4±21.3） minutes vs. （85.3±13.1） minutes）, the AP ablation time （（204±34） seconds vs. （223±62） seconds） and the AP X-ray exposure time （（18.6±4.4） minutes vs. （19.1±4.5） minutes） respectively between groups I and II. As compared with the control group （5 of 10 cases, 50%）, the PVAI group had a significantly lower AF recurrence rate （2 of 19 cases, 11%; P 〈0.05） during follow-up of （20.5±10.0） months. All seven patients who recurred were successfully abolished by a second ablation. Conclusions In patients with pre-excited AF, PVAI is an effective therapeutic approach with a low AF recurrence rate. 3D electroanatomical maps of AP contributed to the high success rate of ablation without significantly prolonging of operational duration and X-ray exposure time.Background Pulmonary vein antrum isolation （PVAI） of pre-excited atrial fibrillation （AF） is controversial. This study aimed to observe the therapeutic effects of PVAI on pre-excited AF. Methods Twenty-nine patients with pre-excited AF were prospectively divided into a PVAI group （group I, 19 cases） and a control group （group II, 10 cases）. To each case in group I, PVAI was performed, and then electroanatomical mapping of accessory pathways （AP） and ablation were constructed on a three-dimensional （3D） map of the valve annulus. Only AP ablation was performed in each case of group II. Results Of the 29 cases, three were found to have dual APs, two had intermittent APs, and the remaining 24 had single APs. All APs were successfully ablated after the procedure. There were no significant statistical differences in the AP procedure duration （（77.4±21.3） minutes vs. （85.3±13.1） minutes）, the AP ablation time （（204±34） seconds vs. （223±62） seconds） and the AP X-ray exposure time （（18.6±4.4） minutes vs. （19.1±4.5） minutes） respectively between groups I and II. As compared with the control group （5 of 10 cases, 50%）, the PVAI group had a significantly lower AF recurrence rate （2 of 19 cases, 11%; P 〈0.05） during follow-up of （20.5±10.0） months. All seven patients who recurred were successfully abolished by a second ablation. Conclusions In patients with pre-excited AF, PVAI is an effective therapeutic approach with a low AF recurrence rate. 3D electroanatomical maps of AP contributed to the high success rate of ablation without significantly prolonging of operational duration and X-ray exposure time.

关 键 词：pre-excitation atrial fibrillation pulmonary vein antrum isolation 3D map 

分 类 号：Q95-33[生物学—动物学] TP391[自动化与计算机技术—计算机应用技术]