Comparative study of left atrial matrix ablation and posterior wall linear isolation ablation strategies in elderly patients with atrial fibrillation
10.19405/j.cnki.issn1000-1492.2022.11.029
- Author:
Hui Xiao
1
;
Haoyang Lu
1
;
Manyu Dai
1
;
Yangcheng Xue
1
;
Zhuoran Jia
1
;
Zhuoran Jia
1
;
Jie Guo
1
;
Ren Zhao
1
Author Information
1. Dept of Cardiology，The First Affiliated Hospitaal of Anhui Medical University，Hefei 230022
- Publication Type:Journal Article
- Keywords:
circumferential pulmonary vein isolation;
left atrial posterior wall isolation;
left atrial matrix mapping;
persistent atrial fibrillation
- From:
Acta Universitatis Medicinalis Anhui
2022;57(11):1844-1848
- CountryChina
- Language:Chinese
-
Abstract:
Objective : In the present study，the changes of left atrial matrix characteristics and the effect of cathe- ter ablation on cardiac function in elderly patients with persistent atrial fibrillation were observed．Furthermore，the application of two catheter ablation methods including circular pulmonary vein isolation combined with left atrial ma- trix modification or left atrial posterior wall isolation were compared by researchers in order to explore effectiveness and safety of the two methods in elderly persistent atrial fibrillation patients．
Methods :A total of 86 elderly pa- tients with persistent atrial fibrillation were selected and divided into two groups using randomization principle ; the pulmonary vein isolation combined with left atrial matrix modified catheter ablation method was named matrix modi- fied group (43 cases) ; the pulmonary vein isolation combined with left atrial posterior wall isolation catheter abla- tion method was named posterior wall isolation group (43 cases) ．During ablation left atrial electro matrix mapping were analyzed by multipole catheter for all patients．After ablation all patients were follow-up in 12 months by car- diac color doppler ultrasound examination，ECG and Holter．The incidence of arrhythmia ，serious adverse event and complications were compared between two groups． Successful rate of single ablation and blank period recur- rence after ablation were observed in 12 months follow-up time.
Results :Through electrogram mapping of left atri- um low-voltage areas or scar areas were founded in 72 cases among the 86 cases after ablation，After a 12-month follow-up，the incidence of arrhythmia in the blank period between the two groups was 41．9% ( matrix modified group) and 23. 3% (posterior wall isolation group) ，independently，P＜0. 01，successful rates of single ablation in the two groups were 83. 7% (matrix modified group) ，60. 5% (posterior wall isolation group) ，independently， P ＜0. 01 ．No adverse event occurred in the two groups．After AF ablation LVEF increased，LVEDD and LVAD significantly decreased in all of the cases．There was no significant difference between the two groups in patients ’ characters ablation time and complications rate．
Conclusion :Circular pulmonary vein isolation combined with left atrial matrix modification is as safe as left atrial posterior wall isolation，and it is a simplified，personalized，and more effective ablation strategy in elderly patients with persistent atrial fibrillation.
- Full text:2024072522112366669基于老年持续性心房颤动患者...性隔离消融策略的对比性研究_肖慧.pdf
