高精密度标测技术在导管消融治疗心律失常中的应用
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摘要
高精密度标测技术是近年来随着三维电解剖标测技术和导管制造技术的进步而产生的概念。目前高精密度标测技术已经应用于各种心律失常的导管消融,因其更高的标测效率和更高的分辨率,有望缩短手术时间、提高手术成功率。本文就高精密度标测技术在心律失常的导管消融中的应用作一综述。
The concept of high-density mapping is developed with the advance of three-dimensional electro-anatomic mapping technology and catheter manufacturing technology. High-density mapping technology has now been applied in catheter ablation for various arrhythmias. Its higher efficiency and resolution may shorten procedure time and improve success rate of surgery. This article will review the application of high-density mapping technique in catheter ablation of arrhythmias.
The concept of high-density mapping is developed with the advance of three-dimensional electro-anatomic mapping technology and catheter manufacturing technology. High-density mapping technology has now been applied in catheter ablation for various arrhythmias. Its higher efficiency and resolution may shorten procedure time and improve success rate of surgery. This article will review the application of high-density mapping technique in catheter ablation of arrhythmias.
引文
[1]Latcu DG,Bun SS,Saoudi N.Ultra-high density sequential mapping of a focal source of atrial fibrillation[J].Europace,2018,20(5):793.DOI:10.1093/europace/eux070.
[2]Kirchhof P,Benussi S,Kotecha D,et al.2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS[J].Eur Heart J,2016,37(38):2893-2962.DOI:10.1093/eurheartj/ehw210.
[3]Ganesan AN,Shipp NJ,Brooks AG,et al.Long-term Outcomes of Catheter Ablation of Atrial Fibrillation:A Systematic Review and Meta-analysis[J].J Am Heart Assoc,2013,2(2):e4549.DOI:10.1161/JAHA.112.004549.
[4]Marrouche NF,Brachmann J,Andresen D,et al.Catheter Ablation for Atrial Fibrillation with Heart Failure[J].N Engl JMed,2018,378(5):417-427.DOI:10.1056/NEJMoa1707855.
[5]Segerson NM,Lynch B,Mozes J,et al.High-density mapping and ablation of concealed low-voltage activity within pulmonary vein antra results in improved freedom from atrial fibrillation compared to pulmonary vein isolation alone[J].Heart Rhythm,2018,15(8):1158-1164.DOI:10.1016/j.hrthm.2018.04.035.
[6]Voskoboinik A,Moskovitch JT,Harel N,et al.Revisiting pulmonary vein isolation alone for persistent atrial fibrillation:Asystematic review and meta-analysis[J].Heart Rhythm,2017,14(5):661-667.DOI:10.1016/j.hrthm.2017.01.003.
[7]Ugarte JP,Tobón C,Orozco-Duque A,et al.Effect of the electrograms density in detecting and ablating the tip of the rotor during chronic atrial fibrillation:an in silico study[J].Europace,2016,17(suppl 2):i97-i104.DOI:10.1093/europace/euv244.
[8]Narayan SM,Krummen DE,Shivkumar K,et al.Treatment of Atrial Fibrillation by the Ablation of Localized Sources[J].J Am Coll Cardiol,2012,60(7):628-636.DOI:10.1016/j.jacc.2012.05.022.
[9]Moller JM,Kowal RC,Swarup V,et al.Initial Independent Outcomes from Focal Impulse and Rotor Modulation Ablation for Atrial Fibrillation:Multicenter FIRM Registry[J].J Cardiovasc Electrophysiol,2014,25(9):921-929.DOI:10.1111/jce.12474.
[10]Tilz RR,Lin T,Rillig A,et al.Focal Impulse and Rotor Modulation for the Treatment of Atrial Fibrillation:Locations and1 Year Outcomes of Human Rotors Identified Using a 64-Electrode Basket Catheter[J].J Cardiovasc Electrophysiol,2017,28(4):367-374.DOI:10.1111/jce.13157.
[11]Alcaine A,de Groot NMS,Laguna P,et al.Spatiotemporal model-based estimation of high-density atrial fibrillation activation maps[J].Digital Signal Processing,2016,54:64-74.DOI:10.1016/j.dsp.2016.04.002.
[12]Kottkamp H,Schreiber D,Moser F,et al.Therapeutic Approaches to Atrial Fibrillation Ablation Targeting Atrial Fibrosis[J].JACC Clin Electrophysiol,2017,3(7):643-653.DOI:10.1016/j.jacep.2017.05.009.
[13]Marrouche NF,Wilber D,Hindricks G,et al.Association of Atrial Tissue Fibrosis Identified by Delayed Enhancement MRIand Atrial Fibrillation Catheter Ablation[J].JAMA,2014,311(5):498-506.DOI:10.1001/jama.2014.3.
[14]Vlachos K,Efremidis M,Letsas KP,et al.Low-voltage areas detected by high-density electroanatomical mapping predict recurrence after ablation for paroxysmal atrial fibrillation[J].JCardiovasc Electrophysiol,2017,28(12):1393-1402.DOI:10.1111/jce.13321.
[15]Pathik B,Lee G,Sacher F,et al.New Insights Into an Old Arrhythmia:High-Resolution Mapping Demonstrates Conduction and Substrate Variability in Right Atrial Macro-Re-Entrant Tachycardia[J].JACC Clin Electrophysiol,2017,3(9):971-986.DOI:10.1016/j.jacep.2017.01.019.
[16]Bun S,Latcu DG,Delassi T,et al.Ultra-High-Definition Mapping of Atrial Arrhythmias[J].Circ J,2016,80(3):579-586.DOI:10.1253/circj.CJ-16-0016.
[17]Choe WC,Sundaram S,Boorman C,et al.High-density mapping of the slow pathway in a patient with atrioventricular nodal reentry given intranasal Etripamil during the NODE-1 study[J].Heart Rhythm Case Rep,2017,3(10):479-482.DOI:10.1016/j.hrcr.2017.07.011.
[18]Maagh P,Christoph A,Müller MS,et al.Point-by-point versus multisite electrode mapping in VT ablation:does freedom from VT recurrences depend on mapping catheter?An observational study[J].J Interv Card Electrophysiol,2018,51(2):169-181.DOI:10.1007/s10840-018-0311-9.
[19]Maagh P,Christoph A,Dopp H,et al.High-Density Mapping in Ventricular Tachycardia Ablation:A Penta Ray?Study[J].Cardiol Res,2017,8(6):293-303.DOI:10.14740/cr636w.
[20]Koutbi L,Maille B,Peyrol M,et al.High-density mapping for catheter ablation of premature ventricular complexes originating from left ventricular papillary muscles:A case series[J].Pacing Clin Electrophysiol,2018,41(9):1071-1077.DOI:10.1111/pace.13417.
[21]Takigawa M,Frontera A,Thompson N,et al.The electrical circuit of a hemodynamically unstable and recurrent ventricular tachycardia diagnosed in 35s with the Rhythmia mapping system[J].J Arrhyth,2017,33(5):505-507.DOI:10.1016/j.joa.2017.06.002.
[22]Berruezo A,Fernandez-Armenta J,Andreu D,et al.Scar Dechanneling:New Method for Scar-Related Left Ventricular Tachycardia Substrate Ablation[J].Circ Arrhyth Electrophysiol,2015,8(2):326-336.DOI:10.1161/CIRCEP.114.002386.
[23]Canoó,Plaza D,SauríA,et al.Utility of high density multielectrode mapping during ablation of scar-related ventricular tachycardia[J].J Cardiovasc Electrophysiol,2017,28(11):1306-1315.DOI:10.1111/jce.13302.
[24]Providência R,Carmo P,Moscoso Costa F,et al.Brugada syndrome is associated with scar and endocardial involvement:Insights from high-density mapping with the Rhythmia?mapping system[J].Rev Port Cardiol,2017,36(10):771-773.DOI:10.1016/j.repc.2017.08.004.
[25]Anter E,Tschabrunn CM,Buxton AE,et al.High-Resolution Mapping of Postinfarction Reentrant Ventricular Tachycardia Clinical Perspective[J].Circulation,2016,134(4):314-327.DOI:10.1161/CIRCULATIONAHA.116.021955.
[2]Kirchhof P,Benussi S,Kotecha D,et al.2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS[J].Eur Heart J,2016,37(38):2893-2962.DOI:10.1093/eurheartj/ehw210.
[3]Ganesan AN,Shipp NJ,Brooks AG,et al.Long-term Outcomes of Catheter Ablation of Atrial Fibrillation:A Systematic Review and Meta-analysis[J].J Am Heart Assoc,2013,2(2):e4549.DOI:10.1161/JAHA.112.004549.
[4]Marrouche NF,Brachmann J,Andresen D,et al.Catheter Ablation for Atrial Fibrillation with Heart Failure[J].N Engl JMed,2018,378(5):417-427.DOI:10.1056/NEJMoa1707855.
[5]Segerson NM,Lynch B,Mozes J,et al.High-density mapping and ablation of concealed low-voltage activity within pulmonary vein antra results in improved freedom from atrial fibrillation compared to pulmonary vein isolation alone[J].Heart Rhythm,2018,15(8):1158-1164.DOI:10.1016/j.hrthm.2018.04.035.
[6]Voskoboinik A,Moskovitch JT,Harel N,et al.Revisiting pulmonary vein isolation alone for persistent atrial fibrillation:Asystematic review and meta-analysis[J].Heart Rhythm,2017,14(5):661-667.DOI:10.1016/j.hrthm.2017.01.003.
[7]Ugarte JP,Tobón C,Orozco-Duque A,et al.Effect of the electrograms density in detecting and ablating the tip of the rotor during chronic atrial fibrillation:an in silico study[J].Europace,2016,17(suppl 2):i97-i104.DOI:10.1093/europace/euv244.
[8]Narayan SM,Krummen DE,Shivkumar K,et al.Treatment of Atrial Fibrillation by the Ablation of Localized Sources[J].J Am Coll Cardiol,2012,60(7):628-636.DOI:10.1016/j.jacc.2012.05.022.
[9]Moller JM,Kowal RC,Swarup V,et al.Initial Independent Outcomes from Focal Impulse and Rotor Modulation Ablation for Atrial Fibrillation:Multicenter FIRM Registry[J].J Cardiovasc Electrophysiol,2014,25(9):921-929.DOI:10.1111/jce.12474.
[10]Tilz RR,Lin T,Rillig A,et al.Focal Impulse and Rotor Modulation for the Treatment of Atrial Fibrillation:Locations and1 Year Outcomes of Human Rotors Identified Using a 64-Electrode Basket Catheter[J].J Cardiovasc Electrophysiol,2017,28(4):367-374.DOI:10.1111/jce.13157.
[11]Alcaine A,de Groot NMS,Laguna P,et al.Spatiotemporal model-based estimation of high-density atrial fibrillation activation maps[J].Digital Signal Processing,2016,54:64-74.DOI:10.1016/j.dsp.2016.04.002.
[12]Kottkamp H,Schreiber D,Moser F,et al.Therapeutic Approaches to Atrial Fibrillation Ablation Targeting Atrial Fibrosis[J].JACC Clin Electrophysiol,2017,3(7):643-653.DOI:10.1016/j.jacep.2017.05.009.
[13]Marrouche NF,Wilber D,Hindricks G,et al.Association of Atrial Tissue Fibrosis Identified by Delayed Enhancement MRIand Atrial Fibrillation Catheter Ablation[J].JAMA,2014,311(5):498-506.DOI:10.1001/jama.2014.3.
[14]Vlachos K,Efremidis M,Letsas KP,et al.Low-voltage areas detected by high-density electroanatomical mapping predict recurrence after ablation for paroxysmal atrial fibrillation[J].JCardiovasc Electrophysiol,2017,28(12):1393-1402.DOI:10.1111/jce.13321.
[15]Pathik B,Lee G,Sacher F,et al.New Insights Into an Old Arrhythmia:High-Resolution Mapping Demonstrates Conduction and Substrate Variability in Right Atrial Macro-Re-Entrant Tachycardia[J].JACC Clin Electrophysiol,2017,3(9):971-986.DOI:10.1016/j.jacep.2017.01.019.
[16]Bun S,Latcu DG,Delassi T,et al.Ultra-High-Definition Mapping of Atrial Arrhythmias[J].Circ J,2016,80(3):579-586.DOI:10.1253/circj.CJ-16-0016.
[17]Choe WC,Sundaram S,Boorman C,et al.High-density mapping of the slow pathway in a patient with atrioventricular nodal reentry given intranasal Etripamil during the NODE-1 study[J].Heart Rhythm Case Rep,2017,3(10):479-482.DOI:10.1016/j.hrcr.2017.07.011.
[18]Maagh P,Christoph A,Müller MS,et al.Point-by-point versus multisite electrode mapping in VT ablation:does freedom from VT recurrences depend on mapping catheter?An observational study[J].J Interv Card Electrophysiol,2018,51(2):169-181.DOI:10.1007/s10840-018-0311-9.
[19]Maagh P,Christoph A,Dopp H,et al.High-Density Mapping in Ventricular Tachycardia Ablation:A Penta Ray?Study[J].Cardiol Res,2017,8(6):293-303.DOI:10.14740/cr636w.
[20]Koutbi L,Maille B,Peyrol M,et al.High-density mapping for catheter ablation of premature ventricular complexes originating from left ventricular papillary muscles:A case series[J].Pacing Clin Electrophysiol,2018,41(9):1071-1077.DOI:10.1111/pace.13417.
[21]Takigawa M,Frontera A,Thompson N,et al.The electrical circuit of a hemodynamically unstable and recurrent ventricular tachycardia diagnosed in 35s with the Rhythmia mapping system[J].J Arrhyth,2017,33(5):505-507.DOI:10.1016/j.joa.2017.06.002.
[22]Berruezo A,Fernandez-Armenta J,Andreu D,et al.Scar Dechanneling:New Method for Scar-Related Left Ventricular Tachycardia Substrate Ablation[J].Circ Arrhyth Electrophysiol,2015,8(2):326-336.DOI:10.1161/CIRCEP.114.002386.
[23]Canoó,Plaza D,SauríA,et al.Utility of high density multielectrode mapping during ablation of scar-related ventricular tachycardia[J].J Cardiovasc Electrophysiol,2017,28(11):1306-1315.DOI:10.1111/jce.13302.
[24]Providência R,Carmo P,Moscoso Costa F,et al.Brugada syndrome is associated with scar and endocardial involvement:Insights from high-density mapping with the Rhythmia?mapping system[J].Rev Port Cardiol,2017,36(10):771-773.DOI:10.1016/j.repc.2017.08.004.
[25]Anter E,Tschabrunn CM,Buxton AE,et al.High-Resolution Mapping of Postinfarction Reentrant Ventricular Tachycardia Clinical Perspective[J].Circulation,2016,134(4):314-327.DOI:10.1161/CIRCULATIONAHA.116.021955.
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