医学
烧蚀
导管消融
心脏病学
内科学
心房颤动
射频消融术
肺静脉
射频导管消融术
窦性心律
作者
Guohua Fu,Bin He,Binhao Wang,Jing Liu,Yibo Yu,Xianfeng Du,Mingjun Feng,Fang Gao,He Jin,Renyuan Fang,Huimin Chu
标识
DOI:10.1007/s10840-018-0470-8
摘要
Transmural lesions (TLs) are the crucial point for radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients. Previous studies have reported that complete positive unipolar electrogram (UP-EGM) after ablation is associated with transmural lesions. However, UP-EGM patterns may differ in different regions of continuous circular lesions (CCLs) around the pulmonary vein ostia after ablation. We aimed to analyze the different UP-EGM patterns in different CCL regions after ablation and the effectiveness of UP-EGM guided RFCA in paroxysmal atrial fibrillation (PAF). A total of 43 patients with PAF (aged 59 ± 11 years; 65% male) were consecutively included. Pulmonary vein isolation was achieved by contiguous point-by-point RFCA. UP-EGM was recorded by the ablation catheter. Both CCLs were divided into six regions. Two points were randomly chosen from each region to analyze UP-EGM type after ablation. All the patients were followed for atrial arrhythmias recurrence. All pulmonary veins were isolated with complete bidirectional block. A total of 1032 RFCA points with complete positive UP-EGM were collected. UP-EGM morphology after ablation was divided into four different types defined as R, rR′, Rr′, and M. M patterns mostly appeared in anterosuperior (65%) and roof (49%) regions of left CCLs. In the remaining regions, the percentage of non-M patterns (R, rR′, and Rr′) ranged from 63% in posteroinferior regions of right CCLs to 88% in anteroinferior regions of right CCLs. After a mean follow-up time of 19 months, 37 (86%) patients remained in sinus rhythm. Most (72%) UP-EGM types after ablation are non-M patterns. Pulmonary vein isolation guided by UP-EGM with a complete positive pattern in PAF patients is reliable.
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