心房颤动导管消融进展—培训课件.pptVIP

Dabigatran VS Warfarin：RE-LY研究 OR 0.80 (0.69–0.93) OR 0.66 (0.53–0.82) Connolly SJ.NEJM.2009:1 CABANA研究比较导管消融与药物治疗 NCT 前瞻、随机、对照研究 入选患者 3,000例 非瓣膜病性房颤 2010年开始入选患者，随访时间 5年 1,500 in 2020 Estimated cases in 2020 = 100,000/yr AF Ablationists: 50 in 2009 中国心房颤动导管消融现状 HRS@GWICC 2009 Access to Health Care 来自于2008年11月JCE的一篇治疗学综述“Dronedarone:A New Treatment for Atrial Fibrillation”，作者是JAMES C. LAUGHLIN, M.D. and PETER R. KOWEY, M.D，来自于Thomas Jefferson University College of Medicine, Main Line Health Heart Center, Wynnewood, Pennsylvania, USA 第一条： 来源于决奈达隆的三个临床研究。 第二条： Athena研究中，房颤患者死亡率的降低临床获益，排除了NYHA IV级的患者以及心衰急性加重者； 第三条： 由此可以推断，决奈达隆的适应证是否也是射频消融的适应证？ 第四条： 此类患者可能胺碘酮可能有使用价值。 意大利 Objectives： The purpose of this study was to assess the efficacy and safety of a novel, multielectrode, duty-cycled radiofrequency ablation (RFA) system for long-standing persistent atrial fibrillation (AF). Background RFA for persistent AF remains a lengthy and challenging procedure. Methods：In 5 European centers, 50 patients with long-standing persistent AF underwent RFA. A circular pulmonary vein (PV) ablation catheter was used for PV isolation. Complex fractionated atrial electrograms were targeted at the interatrial septum using a multiarray septal ablation catheter and in the left atrium using a multiarray ablation catheter. Results：During a mean total procedure time of 155+-40 min, complete PV isolation and complex fractionated atrial electrogram ablation were achieved in all patients. In 50% of patients, redo ablation was performed using the same strategy and technology. There were no device-related adverse events. At 6 months, a 7-day Holter electrocardiogram showed 80% AF reduction in 40 of 50 patients (80%), and 32 of 50 (64%) were off antiarrhythmic drugs. At 20 4 months after the last procedure, 31 of 47 patients (66%) had a 80% reduction in AF burden, with 21 patients (45%) free of AF and off antiarrhythmic drugs. Conclusions This initial 50-patient multicenter study demo