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Use of electrical coupling information in AF catheter ablation: a prospective randomized pilot study.

Abstract：

BACKGROUND:Catheter contact is important for radiofrequency (RF) ablation. Local electrical catheter-to-tissue coupling has been described as a tool to objectively measure contact. OBJECTIVE:We hypothesized that pulmonary vein isolation (PVI) ablation using electrical coupling information (ECI) would yield higher rates of PVI than an approach without ECI. METHODS:Forty patients with atrial fibrillation were prospectively included. In each patient, 1 pair of pulmonary veins (PVs) was randomly chosen to be encircled with ECI available while the other pair was encircled without use of ECI. RESULTS:The rate of PVI was significantly higher in PVs encircled with ECI available (58% vs 30%; P = .024). PV encircling with coupling resulted in slightly longer procedure (26.5 [interquartile range {IQR} 22-32.5] vs 23.5 [IQR 19-26.5] minutes; P = .019), fluoroscopy (9.0 [IQR 6-12] vs 6.9 [IQR 4-8.6] minutes; P = .011), and RF (20.0 [IQR 16.5-23.5] vs 17.3 [IQR 15.1-20.6] minutes; P = .015) times. For nonisolated PVs, the coupling group had significantly fewer gaps (3.0 [IQR 1.8-7] vs 6.0 [IQR 4-11]; P = 0.021) and gap mapping/closure needed shorter procedure (9.0 [IQR 4-16] vs 13.0 [IQR 11-21] minutes; P = .04), fluoroscopy (3.9 [IQR 2-7.1] vs 6.0 [IQR 4.6-7.9] minutes; P = .038), and RF (1.9 [IQR 0.9-5] vs 5.2 [IQR 3.3-8.6] minutes; P = .016) times. CONCLUSIONS:The use of ECI improved lesion deployment measured as higher rates of PVI after anatomical encircling. For nonisolated PVs, fewer gaps and faster gap closure were found using ECI.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Gaspar T,Sih H,Hindricks G,Eitel C,Sommer P,Kircher S,Rolf S,Arya A,Teplitsky L,Piorkowski C

doi

10.1016/j.hrthm.2012.10.010

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

176-81

issue

2

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(12)01199-X

journal_volume

10

pub_type

杂志文章,随机对照试验

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