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首页> 外文期刊>Journal of cardiovascular electrophysiology >Feasibility of a left atrial electrical disconnection procedure for atrial fibrillation using transcatheter radiofrequency ablation.
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Feasibility of a left atrial electrical disconnection procedure for atrial fibrillation using transcatheter radiofrequency ablation.

机译：使用经导管射频消融术治疗左心房纤颤的可行性。

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INTRODUCTION: An effective, catheter-based treatment for persistent atrial fibrillation (AF) remains elusive. This study assessed the feasibility of transcatheter left atrial (LA) electrical disconnection and its effect on AF inducibility. METHOD AND RESULTS: Thirteen anesthetized swine underwent noncontact mapping of the right atrium (RA) during coronary sinus (CS) pacing. Sites of earliest RA activation were identified using isopotential maps. An ablation catheter was navigated to these sites and a cluster of radiofrequency (RF) lesions applied until earliest activation shifted to a new site. The procedure was repeated until the atria were electrically disconnected. AF induction was attempted before and after ablation. Earliest RA activation was the CS os during proximal CS pacing and Bachmann's bundle during distal CS pacing. These two sites were successfully ablated in all 13 animals. Earliest activation then shifted to the fossa ovalis. RF energy was applied at a median of 2.5 sites (range 1 to 5) around the fossa, then at sites in the triangle of Koch, septum, cavotricuspid isthmus, and posterior wall. Atrial electrical disconnection was achieved in 10 of 13 animals (5 LA electrical disconnection, 3 RA electrical disconnection, 2 biatrial electrical disconnection with complete heart block). After atrial electrical disconnection, the LA became electrically silent. Before ablation, AF was inducible in every animal. After atrial electrical disconnection, AF was inducible in 3 of 10 animals. CONCLUSION: Atrial electrical disconnection is feasible using noncontact mapping and RF ablation. Successful electrical disconnection of the atria reduces AF inducibility. This approach is worthy of further evaluation as a management strategy for persistent AF, combined with device therapies.
机译：简介：有效的，基于导管的持续性心房纤颤（AF）治疗仍然难以捉摸。这项研究评估了经导管左心房（LA）电断开的可行性及其对房颤诱发性的影响。方法和结果：13例麻醉的猪在冠状窦（CS）起搏期间进行了右心房（RA）的非接触性测绘。使用等电位图鉴定了最早的RA激活位点。将消融导管导航到这些部位，并施加一簇射频（RF）损伤，直到最早的激活转移到一个新部位。重复该过程直到心房被电断开。在消融之前和之后尝试进行房颤诱导。最早的RA激活是近端CS起搏期间的CS os和远端CS起搏期间的Bachmann束。在所有13只动物中，这两个部位均被成功消融。最早的激活然后转移到卵圆窝。 RF能量施加在窝周围的2.5个部位（范围1至5）的中位，然后施加在科赫三角形，隔膜，左室窦峡部和后壁的部位。在13只动物中的10只中实现了心房电断开（5个LA电断开，3个RA电断开，2个双心室电断开，并伴有完全的心脏传导阻滞）。房电断开后，LA变为电静默状态。消融前，每只动物均可诱发房颤。房电断开后，可在10只动物中的3只中诱发房颤。结论：使用非接触式映射和射频消融术可实现房间断电。成功断开心房的电连接会降低房颤的诱发性。这种方法作为持续性房颤的治疗策略，结合器械疗法，值得进一步评估。

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