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Chinese Medical Journal 2011年第10期124卷 1586-1587页

作者： miao cheng-long sang cai-hua dong jian-zeng ma chang-sheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Ablation of persistent atrial fibrillation is still a challenge for the ablationist. Extensive ablation is required under some conditions and could lead to some unintended complications. Here we report a case of atrium-atrioventricular node block complicating multiple catheter ablation procedures for persistent atrial fibrillation. After extensive ablation, including circumferential pulmonary vein ablation, linear ablation at the left atrial roof, mitral isthmus, atrial septum, cavotricuspid isthmus, and complex fractionated atrial electrogram ablation, conduction obstacle was found, and sinus impulse could not travel from the right atrium, atrial septum and left atrium to atrioventricular node. The case indicated that intensive ablation at some key sites, especially the interatrial septum, should be careful during ablation of atrial fibrillation

关键词： atrialfibrillation catheter ablation complications

long-term results of single-procedure catheter ablation for atrial fibrillationin pre-and post-menopausal women

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Journal of Geriatric Cardiology 2014年第2期11卷 120-125页

作者： Tao LIN Xing DU Rong BAI Ying-Wei CHEN Rong-Hui YU De-Yong long Ri-Bo TANG cai-hua sang Song-Nan LI chang-sheng ma jian-zeng dong Department of Cardiology Beijing Anzhen Hospital Capital Medical University Anzhen Road Chao Yang District Beijing 100029 China

Objectives To address whether menopause affects outcome of catheter ablation （CA） for atrial fibrillation （AF） by comparing the safety and long-term outcome of a single-procedure in pre-and post-menopausal women. Methods A total of 743 female patients who underwent a single CA procedure of drug-refractory AF were retrospectively analyzed. The differences in clinical presentation and outcomes of CA for AF between the pre-menopausal women （PreM group, 94 patients, 12.7%） and the post-menopausal women （PostM group, 649 patients, 87.3%） were assessed. Results The patients in the PreM group were younger （P＆lt;0.001） and less likely to have hypertension （P＆lt;0.001） and diabetes （P=0.005） than those in the PostM group. The two groups were similar with regards to the proportion of concomitant mitral valve regurgitation coronary artery disease, left atrium dimensions, and left ventricular ejection fraction. The overall rate of complica-tions related to AF ablation was similar in both groups （P=0.385）. After 43 （16-108） months of follow-up, the success rate of ablation was 54.3%in the PreM group and 54.2%in the PostM group （P=0.842）. The overall freedom from atrial tachyarrhythmia recurrence was simi-lar in both groups. Menopause was not found to be an independent predictive factor of the recurrence of atrial tachyarrhythmia. Conclusions The long-term outcomes of single-procedure CA for AF are similar in pre-and post-menopausal women. Results indicated that CA of AF appears to be as safe and effective in pre-menopausal women as in post-menopausal women.

关键词： Atrial fibrillation Catheter ablation Follow-up Menopausal woman

Catheter ablation of persistent atrial fibrillation in a patient with dextrocardia

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Chinese Medical Journal 2012年第10期125卷 1839-1840页

作者： XUE zeng-ming sang cai-hua dong jian-zeng ma chang-sheng Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

Dextrocardia is a rare anomaly where the heart is located on the right side of the chest instead of the normal left side. Ablation of atrial fibrillation （AF） with such an inverted anatomy may be challenging for the manipulation of the catheters. Here we report a case of dextrocardia who underwent ablation for persistent AF guided by image integration system.

关键词： dextrocardia atrialfibrillation ablation

Catheter ablation of persistent atrial fibrillation with and without a history of paroxysmal atrial fibrillation

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Chinese Medical Journal 2012年第6期125卷 1175-1178页

作者： miao cheng-long YIN Xian-dong dong jian-zeng LIU Xing-peng YU Rong-hui long De-yong TANG Ri-bo sang cai-hua ma chang-sheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China Beijing Chaoyang Hospital Capital Medical University Beijing 100020 China.

Background It is unclear whether a history of paroxysmal atrial fibrillation （PAF） would impact the effect of catheter ablation on persistent atrial fibrillation （AF）. This study aimed to compare the effect of catheter ablation on persistent AF with and without a history of PAF. Methods One hundred and eighty-three patients underwent catheter ablation of persistent AF lasting for 〉1 month and were reviewed. Patients were divided into two groups according to whether they had a history of PAF or not. Group I consisted of persistent AF patients with a history of PAF, and group II consisted of persistent AF patients without such a history. All patients received catheter ablation focused on pulmonary vein isolation and were observed for arrhythmia recurrences, which were defined as documented episodes of AF or atrial tachycardia after a blanking period of 3 months. Results One hundred and three patients （60.9%） in group I and sixty-six patients （39.1%） in group II were successfully followed and included in analysis. There were no significant differences in clinical and echocardiographic characteristics between both groups except for a younger age and more male patients in group II. After （15.5±10.7） months of follow-up, 59 （57.3%） patients in group I and 49 （74.2%） patients in group II maintained sinus rhythm free of anti-arrhythmia drugs （P=0.025）. Multivariate analyses found left atrial anteroposterior diameter （P=0.006） and persistent AF with a history of PAF （OR 1.792, 95% CI 1.019-3.152; P=0.043） as the only independent statistical predictors of arrhythmia recurrences. Conclusion The arrhythmia recurrence rate of catheter ablation based on pulmonary vein isolation in persistent AF with a history of PAF was hiQher than those without a history of PAF

关键词： atrial fibrillation radiofrequency ablation recurrence

Catheter ablation for atrial fibrillation is associated with reduced risk of mortality in the elderly:a prospective cohort study and propensity score analysis

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Journal of Geriatric Cardiology 2020年第12期17卷 740-749页

作者： Xin SU Xin DU Shang-Xin LU Chao jianG Jing DU Shi-Jun XIA Zhao-Jie dong Zhao-Xu JIA De-Yong long cai-hua sang Ri-Bo TANG Nian LIU Song-Nan LI Rong BAI jian-zeng dong chang-sheng ma Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina Heart Health Research Center BeijingChina The George Institute for Global Health Faculty of MedicineUniversity of New South WalesSydneyAustralia Beijing Centre for Disease Prevention and Control BeijingChina

Background It is unclear whether catheter ablation(CA)for atrial fibrillation(AF)affects the long-term prognosis in the *** study aims to evaluate the relationship between CA and long-term outcomes in elderly patients with *** Patients more than 75 years old with non-valvular AF were prospectively enrolled between August 2011 and December 2017 in the Chinese Atrial Fibrillation Registry *** who underwent CA at baseline were propensity score matched(1:1)with those who did not receive *** outcome events included all-cause mortality,cardiovascular mortality,stroke/transient ischemic attack(TIA),and cardiovascular *** Overall,this cohort included 571 ablated patients and 571 non-ablated patients with similar characteristics on 18 *** a mean follow-up of 39.75±19.98 months(minimum six months),24 patients died in the ablation group,compared with 60 deaths in the non-ablation group[hazard ratio(HR)=0.49,95%confidence interval(CI):0.30-0.79,P=0.0024].Besides,6 ablated and 29 non-ablated subjects died of cardiovascular disease(HR=0.25,95%CI:0.11-0.61,P=0.0022).A total of 27 ablated and 40 non-ablated patients suffered stroke/TIA(HR=0.79,95%CI:0.48-1.28,P=0.3431).In addition,140 ablated and 194 non-ablated participants suffered cardiovascular hospitalization(HR=0.84,95%CI:0.67-1.04,P=0.1084).Subgroup analyses according to gender,type of AF,time since onset of AF,and anticoagulants exposure in initiation did not show significant *** In elderly patients with AF,CA may be associated with a lower incidence of all-cause and cardiovascular mortality.

关键词： Atrial fibrillation Catheter ablation Mortality Stroke The elderly

Epicardial isolation of pulmonary veins with ethanol in open chest dogs

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Chinese Medical Journal 2011年第11期124卷 1714-1719页

作者： YIN Xian-dong NING man sang cai-hua miao cheng-long LIANG Cui TANG Ri-bo long De-yong YU Rong-hui LIU Xing-peng dong jian-zeng ma chang-sheng Department of Cardiology Beijing Anzhen Hospital CapitalMedical University Beijing 100029 China

Background Radiofrequency （RF） ablation has become a widely accepted treatment for atrial fibrillation （AF）. This study aimed to identify the efficacy and safety of pulmonary vein （PV） ablation with ethanol and to explore an alternative energy source for catheter ablation of AF. Methods Twelve open-chest mongrel dogs were randomized into ethanol ablation group and control group. Both the injections and electrophysiological mapping procedures were performed epicardialy. In ethanol ablation group （n=-6）, injections were performed to circumferentially ablate the root of each PV （0.2 ml each site, 3 mm apart） with 95% ethanol using an 1 ml injector. In control group （n=6）, saline was injected other than ethanol.

关键词： ethanol pulmonary vein isolation epicardial atrial fibrillation

Late intra-atrial reentrant tachycardia would be prevented by ablation of right atrial potential isthmuses during the surgical operation for congenital heart disease

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Chinese Medical Journal 2010年第18期123卷 2613-2615页

作者： sang cai-hua dong jian-zeng LIU Xing-peng YU Rong-hui long De-yong TANG Ri-bo ma chang-sheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Intra-atrial reentrant tachycardia （IART） is not uncommon after surgical correction of congenital heart disease （CHD）. The patients with IART are often refractory to antiarrhymic agents and present with severe symptoms. Current treatment approach to IART has shifted largely to interventional procedures which have a good short-term success rate, however, late recurrence rate is still high. With the development of mapping technique especially the application of three-dimensional electroanatomic mapping,

关键词： congenital heart disease intra-atrial reentrant tachycardia prevention ablation

Mechanisms of organized atrial tachycardia during catheter ablation of chronic atrial fibrillation by stepwise approach

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Chinese Medical Journal 2010年第7期123卷 852-856页

作者： NING man dong jian-zeng LIU Xing-peng YU Rong-hui long De-yong TANG Ri-bo sang cai-hua ma chang-sheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Background Extensive atrial fibrillation （AF） ablation is associated with an increased success rate of catheter ablation in chronic AF patients and an increased rate of atrial tachycardia （AT） during the procedure. The mechanism of these Ats varies in previous studies. Our study aimed to report the mechanism of organized AT occurring during the stepwise ablation procedure of chronic *** A prospective cohort of 86 consecutive patients who underwent an ablation procedure for chronic atrial fibrillation （CAF） was investigated. The stepwise procedure was performed in the following order： circumferential pulmonary vein ablation, complex fractionated atrial electrograms ablation, mapping and ablation of AT. The endpoint was noninducibility of AF/AT after sinus rhythm （SR） was restored or the procedure time was beyond 6 *** Sixty-nine （80%） of patients converted to SR via AT. A total of 179 sustained ATs were observed in 69 patients during the procedure. There were 81% （n=145） macroreentrant ATs which included 65 perimitral circuits, 48 peritricuspid tachycardia and 32 roof dependent circuits, 12% （n=21） localized reentrant and 7% （n=13） focal ATs. Thirty （15%） patients experienced significant left atrium （LA） and LA appendage （LAA） conduction delay or dissociation in the procedure or during the follow-up *** Most CAF patients converted to SR via ablation of organized AT occurring during the stepwise procedure. The mechanism of most of these ATs was macro-reentry.

关键词： organized atrial tachycardia chronic atrial fibrillation catheter ablation stepwise approach

Impact of different termination modes on atrial fibrillation termination in catheter ablation of persistent atrial fibrillation

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Chinese Medical Journal 2012年第11期125卷 1877-1883页

作者： WANG Ping dong jian-zeng long De-yong NING man TANG Ri-bo YU Rong-hui XUE zeng-ming sang cai-hua jianG Chen-xi ma chang-sheng Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

Background The optimal endpoint for catheter ablation of persistent atrial fibrillation （AF） remains ambiguous. This study investigated the impact of AF termination as a procedural endpoint and the termination mode on long-term clinical outcome. Methods Two hundred and ninety-three patients who underwent stepwise ablation for persistent AF were categorized into the AF termination by ablation group and into the electrical cardioversion （CV） group. Subgroups were also analyzed based on different termination modes. Follow-up assessment included early recurrence and sinus rhythm （SR） maintenance. Results During initial ablation, 33 patients （11.3%） were directly converted to SR, 166 patients （56.7%） were converted to atrial tachycardia （AT） that subsequently restored SR with further ablation in 98 patients （33.4%）, and a total of 162 patients （55.3%） underwent cardioversion due to persistent atrial arrhythmias. Comparison between termination by ablation and termination by cardioversion in patients exhibiting AF or AT revealed that no significant difference was observed in early recurrence （38.2% vs. 43.8%, P=0.328） and SR maintenance （67.2% vs. 59.8%, P=0.198） during the （23±7） months follow-up. Even after repeat ablation, the SR maintenance continued to exhibit no statistical difference in above two groups （72.5% vs. 70.4%, P=0.686）. Further analysis of subgroups, however, demonstrated that patients with AF terminated directly to SR experienced better clinical outcomes than other subgroups （P 〈0.05）. Furthermore, atrial arrhythmias present during ablation have been implicated in prediction of recurrence mode： AF or AT （P 〈0.05）. Conclusions Termination as a procedural endpoint is not associated with favorable long-term SR maintenance in persistent AF. AF methods that convert arrhythmia directly to SR have, however, been linked with improved clinical outcomes, although conversions to AT may not be correlated. Atrial arrhythmias observed during the ablation may be used t

关键词： persistent atrial fibrillation catheter ablation termination sinus rhythm maintenance recurrence

Efficacy of catheter ablation of atrial fibrillation beyond HATCH score

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Chinese Medical Journal 2012年第19期125卷 3425-3429页

作者： TANG Ri-bo dong jian-zeng long De-yong YU Rong-hui NING man jianG Chen-xi sang cai-hua LIU Xiao-hui ma chang-sheng Department of Cardiology Beijing An Zhen HospitalCapital Medical UniversityBeijing Institute of Heart Lung and Blood Vessel DiseasesBeijing 100029China

Background HATCH score is an established predictor of progression from paroxysmal to persistent atrial fibrillation （AF）. The purpose of this study was to determine if HATCH score could predict recurrence after catheter ablation of AF. Methods The data of 488 consecutive paroxysmal AF patients who underwent an index circumferential pulmonary veins （PV） ablation were retrospectively analyzed. Of these patients, 250 （51.2%） patients had HATCH score=0, 185 （37.9%） patients had HATCH score=l, and 53 （10.9%） patients had HATCH score 〉2 （28 patients had HATCH score=2, 23 patients had HATCH score=3, and 2 patients had HATCH score=4）. Results The patients with HATCH score 〉2 had significantly larger left atrium size, the largest left ventricular end systolic diameter, and the lowest ejection fraction. After a mean follow-up of （823＋532） days, the recurrence rates were 36.4%, 37.8% and 28.3% from the HATCH score=0, HATCH score=l to HATCH score 〉2 categories （P=0.498）. Univariate analysis revealed that left atrium size, body mass index, and failure of PV isolation were predictors of AF recurrence. After adjustment for body mass index, left atrial size and PV isolation, the HATCH score was not an independent predictor of recurrence （HR=0.92, 95% confidence interval=0.76-1.12, P=0.406） in multivariate analysis. Conclusion HATCH score has no value in prediction of AF recurrence after catheter ablation.

关键词： HATCH score atrial fibriUation catheter ablation