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radiofrequency catheter ablation OF PERMANENT ATRIAL FIBRILLATION UNDER GUIDANCE OF CARTO-MERGE TECHNIQUE

Chinese Medical Sciences Journal 2007年第3期22卷 156-161页

作者： Zhen-fang Ren Pi-hua Fang Fu-sheng Ma Jian-min Chu Jian Ma Shu Zhang Center of Arrhythmia Diagnosis and Treatment Cardiovascular Institute ＆ Fuwai HospitalChinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100037

Objective To investigate the feasibility and effectiveness of radiofrequency catheter ablation (RFCA) to treat permanent atrial fibrillation (AF) under the guidance of Carto-Merge technique. Methods Fifteen male patients with permanent AF underwent RFCA under the guidance of Carto-Merge technique. The mean age was 54.00±10.44 years, and duration of AF was 23.66±14.93 months. Cardiac magnetic resonance angiography (MRA) was performed to obtain pre-procedural three-dimensional (3D) images on the anatomy of left atrium (LA) and pulmonary veins (PVs) before RFCA procedure. Then the electroanatomical map was integrated with 3D images of MRA to form Carto-Merge map that guided step-by-step ablation strategy of permanent AF. Circumferential PV ablation was performed first until complete PVs electric isolation confirmed by Lasso catheter. If AF was not terminated, lesion lines on roof of LA, mitral isthmus, and tricuspid isthmus were produced. Results The episodes of AF were terminated during RFCA in 2 patients, by direct current cardioversion in the remaining 13 patients. Transient AF occurred in 2 patients after ablation on 1st day and 1st week respectively, AF terminated spontaneously not long after taking metoprolol. One patient developed persistent atrial flutter (AFL) in 2 months after procedure and AFL was eliminated by the second ablation. Persistent AF recurred on 1st day, 1st and 5th week respectively in 3 patients, and did not terminate after 3 months even though amiodarone was given. The remaining 12 patients were all free of AF during 2-11 months of follow-up. The recent success rate for RFCA of permanent AF was 80%. Conclusions Carto-Merge technique can effectively guide RFCA of permanent AF. When combined with single Lasso mapping, it can simplify the mapping, lower expenses, and enhance the success rate of RFCA of permanent AF.

关键词： radiofrequency catheter ablation atrial fibrillation Carto-Merge magnetic resonance angiography

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radiofrequency catheter ablation of idiopathic ventricular tachycardia and symptomatic premature ventricular contraction originating from valve annulus

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Chinese Medical Journal 2008年第22期121卷 2241-2245页

作者： WU Xiao-yu LIANG Zhao-guang TAN Zhen GU Hong-yue ZHANG Shu LI Wei-min Department of Cardiology First Affiliated Hospital of Harbin Medical University Harbin Heilongjiangl50001 China

Background radiofrequency catheter ablation （RFCA） has been established as an effective and curative therapy for ventricular tachycardia （VT） and severely symptomatic premature ventricular contraction （PVC） from the outflow tract in structurally normal hearts. This study aimed to investigate electrophysiologic characteristics and effects of RFCA for patients with idiopathic VT and symptomatic PVC originating from the valve annulus. Methods Characteristics of body surface electrocardiogram （ECG） and endocardiogram in a successful RFCA target were analyzed in 16 patients with idiopathic VT and symptomatic PVC originating from the valve annulus. Additionally, the ECG characteristics of VT or PVC were compared with those of manifest Wolff-Parkinson-White （WPW） syndrome originating from the same site of origin in 15 patients. Results Thirteen patients were successful, 2 recurrent and 1 failed. The recurrent cases underwent successful ablation the second time guided by the Ensite 3000 mapping system. In all patients with the WPW syndrome, the characteristics of QRS morphology were well matched with those of the VT and PVC that originated from corresponding sites of origin. Conclusions RFCA is an effective curative therapy for VT and There are specific characteristics in ECG and the ablation site accessory pathway＇s algorithm. symptomatic PVC originating from the valve annulus. could be located by means of the WPW syndrome

关键词： ventricular tachycardia valve annulus radiofrequency catheter ablation

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Delayed papillary muscle rupture after radiofrequency catheter ablation: A case report

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World Journal of Clinical Cases 2021年第20期9卷 5556-5561页

作者： Ze-Wei Sun Bi-Feng Wu Xuan Ying Bi-Qi Zhang Lei Yao Liang-Rong Zheng Department of Cardiology Zhejiang UniversityHangzhou 310000Zhejiang ProvinceChina

BACKGROUND With an increased number of surgical procedures involving the mitral annular region,the risk of mitral valve prolapse(MVP)has also *** studies have reported that worsening of MVP occurred early after radiofrequency catheter ablation(RFCA)at papillary muscles in ventricular tachycardia(VT)patients with preoperative *** SUMMARY We report a case where MVP and papillary muscle rupture occurred 2 wk after RFCA in a papillary muscle originated VT patient without mitral valve regurgitation or prolapse *** patient then underwent mitral valve replacement with no premature ventricular contraction or *** the surgery,a papillary muscle rupture was *** examination showed necrosis of the papillary *** patient recovered after mitral valve *** Too many ablation procedures and energy should be avoided.

关键词： Mitral valve prolapse radiofrequency catheter ablation Ventricular tachycardia Mitral valve replacement Dyspnea papillary muscles Case report

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Role of a new inflammation predictor in predicting recurrence of atrial fibrillation after radiofrequency catheter ablation

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World Journal of Cardiology 2024年第12期16卷 740-750页

作者： Yu-Jie Wang Ke-Sen Liu Xiang-Jiang Meng Xue-Fu Han Lu-Jing Nie Wen-Jiu Feng Yan-Bo Chen Department of Cardiology Changle People’s HospitalShandong Second Medical University Affiliated HospitalWeifang 261000Shandong ProvinceChina Department of Arrhythmia Weifang People's HospitalWeifang 261000Shandong ProvinceChina

BACKGROUND radiofrequency catheter ablation(RFCA)has become an important strategy for treating atrial fibrillation(AF),and postoperative recurrence represents a significant and actively discussed clinical *** recurrence after RFCA is considered closely related to *** immune inflammation index(SII)is a novel inflammation predictor based on neutrophils,platelets,and lymphocytes,and is considered a biomarker that comprehensively reflects the immune inflammatory status of the *** To explore the predictive effect of the SII on AF recurrence after RFCA and its predictive value in combination with the existing APPLE score for AF recurrence after RFCA in patients with non-valvular AF(NVAF).METHODS We retrospectively included 457 patients with NVAF first receiving RFCA and classified them into the recurrent or non-recurrent *** also investigated the predictive role of SII on AF recurrence following ***,we explored and compared the additional predictive value of the SII after combining with the APPLE *** After 12 months of follow-up,113(24.7%)patients experienced *** SII has been demonstrated to be an independent predictor for postoperative AF *** operating characteristic and decision curve analysis(DCA),as well as net reclassification improvement(NRI)and integrated discrimination improvement(IDI)results,showed that SII combined with the APPLE score had higher predictive efficiency than using the SII or APPLE score *** area under the curve of the combined model(0.662,95%confidence interval:0.602-0.722)significantly increased compared with that of the SII and APPLE scores alone(P<0.001).The combined model resulted in an NRI of 29.6%and 34.1%and IDI of 4.9%and 3.5%in predicting AF recurrence compared with the SII and APPLE scores alone,respectively(all P<0.001).The SII,APPLE score,and their combination demonstrated greater clinical utility than did the treat-all and treat-none strategies ov

关键词： Systemic immune inflammation index Atrial fibrillation radiofrequency catheter ablation APPLE score Recurrence

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Metabolic benefits of rivaroxaban in non-valvular atrial fibrillation patients after radiofrequency catheter ablation

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2017年第11期18卷 946-954页

作者： Jun ZHU Rong-jun GAO Qiang LIU Ru-hong JIANG Lu YU Ya-xun SUN Pei ZHANG Jian-wei LIN Yang YE Zu-wen ZHANG Shi-quan CHEN Hui CHENG Xia SHENG Chen-yang JIANG Department of Cardiology Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhou 310016China Traditional Chinese Medicine Hospital of Wuhu Anhui 241000China

Background and objective： Rivaroxaban is a new oral anticoagulant for stroke prevention in patients with non-valvular atrial fibrillation （NVAF）, which has less drug-food interaction than warfarin. We conducted this pro- spective randomized study to evaluate the metabolic benefits as well as the safety and efficacy with rivaroxaban versus warfarin in patients with NVAF following radiofrequency catheter ablation （RFCA）. Methods： From April to July 2014, 60 patients with NVAF undergoing RFCA were prospectively enrolled in our study. Following RFCA, all patients were randomly assigned to receive rivaroxaban （Group R, n=30） or warfarin （Group W, n=30）. Metabolic indices including serum total protein, albumin, globulin, and high-density lipoprotein （HDL） as well as bleeding, stroke, and systemic thromboembolism events were evaluated and compared during follow-up after 15, 30, 60, and 90 d of RFCA procedure. Results： Serum total protein, albumin, globulin, and HDL levels were all significantly elevated at each follow-up stage in Group R when compared to the baseline （P〈0.05 respectively）. In Group W, the metabolic indices decreased at first and then had an increasing trend. There were no deaths or thromboembolic complications in each group. The prevalence of total bleeding complications was similar between Group R and Group W （11/30, 36.7% vs. 10/30, 33.3%, P=0.70）. Conclusions： Patients with NVAF receiving rivaroxaban after RFCA procedures appear to benefit from a metabolic perspective compared with warfarin, providing practical clinical reference for the choice of the anticoagulant. Rivaroxaban seems to be as safe and effective in preventing thromboembolic events as warfarin for these patients.

关键词： Atrial fibrillation radiofrequency catheter ablation Anticoagulation Rivaroxaban

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Right phrenic injury after radiofrequency catheter ablation of atrial tachycardia at crista terminalis

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Chinese Medical Journal 2011年第10期124卷 1588-1589页

作者： JIA Yu-he WANG Fang-zheng GAO Dong-sheng CHU Jian-min PU Jie-ling REN Xiao-qing HUA Wei ZHANG Shu Cardiac Arrhythmia Center Cardiovascular Institute & Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing 100037 China Division of Cardiology The Hospital for Sick Children University of Toronto Toronto Canada

A 62-year-old woman with frequent occurrence of symptomatic atrial tachycardia with a foci located at the root of the upper crista terminalis was found to have right diaphragm paresis after receiving a total of 8 radiofrequency energy deliveries （40-60 W, 50-60℃） and a total duration of 540 seconds of ablation therapy （7Fr 8 mm deflectable ablation catheter）. The right diaphragm paresis remained resolved up to 14 months after the procedure as confirmed by repeated chest X-rays.

关键词： right phrenic injury radiofrequency catheter ablation atrial fibrillation crista terminalis

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Continuous infusion of midazolam and fentanyl during cryoballoon ablation compared with during radiofrequency catheter ablation of atrial fibrillation:Results from a retrospective study

Continuous infusion of midazolam and fentanyl during cryobal...

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2015年中国药学大会暨第十五届中国药师周

作者： Xu Liu Xiao-gang Guo Gong-bu Zhou Jian-du Yang Qi Sun Keping Chen Jian Ma Shu Zhang Arrhythmias Center State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Aims Cryoballoon ablation（CBA） or radiofrequency catheter ablation（RFCA） of atrial fibrillation（AF） can be performed under sedation/analgesic. We sought to investigate the feasibility, safety with continuous infusion of midazolam and fentanyl for CBA and *** and Results One hundred and sixty paroxysmal atrial fibrillation patients were enrolled into two groups by ablation technique used（CBA or RFCA, 80 patients for each group）. We recorded patient characteristics and perioperative data including peripheral oxygen saturation, heart rate, and noninvasive blood pressure. Dosage of midazolam was not significantly different between the two groups（13.7 ± 1.6 mg in CBA vs. 13.7 ± 1.8 mg in RFCA, P=0.11）. However, dosage of fentanyl was significantly less in CBA group（199.0 ± 26.5 μg vs. 278.5 ± 31.8 μg, P＜0.001）. Frequency of applied oropharyngeal airway due to upper airway obstruction or desaturation（SpO2＜90%） was significantly lower in CBA group（30 vs. 44, P=0.03）, while the incidence of restlessness was similar between the two groups. There were 3 patients in RFCA group who left atrial geometry required remapping because restlessness influenced the reference patch. The Ramsay sedation score（RSS） was similar between groups, while operator satisfaction score was significantly higher in CBA group（3.1 ± 0.5 vs. 2.8 ± 0.7, P=0.01）. Conclusion Continuous infusion of midazolam and fentanyl by cardiologists wasfeasible and safe for CBA and mostly RFCA of atrial fibrillation. A higher operator satisfaction level was obtained for CBA of atrial fibrillation.

关键词： Sedation Midazolam Fentanyl Cryoballoon ablation radiofrequency catheter ablation Atrial fibrillation

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Delayed injury of autonomic nerve induced by radiofrequency catheter ablation

Delayed injury of autonomic nerve induced by radiofrequency ...

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2008年钱江国际心血管病会议暨浙江省心血管病年会

作者： Jufang Chi Hangyuan Guo Ping Wang Yangbo Xing Fang Peng Biao Yang Binquan You Yufang Qiu Department of Cardiology Shaoxing People’s Hospital The First Affiliated Hospital of Shaoxing University of China

＜正＞Objective:radiofrequency catheter ablation（RFCA） is the curative treatment of choice for many cardiac arrhythmias and may cause myocardial injury and inappropriate sinus *** study aimed to determine the delayed injury of autonomic nerve following ***:Spectral analysis of heart rate variation（HRV） on 24-hour Holter ECG recordings was carded out in 86 cases（39 females,47 males,mean age 42 years,rang 17-67 years） with paroxysmal supraventricular tachycardia（PSVT） 1 hour before and 1 year after successful RFCA（WPW type A=31,WPW type B=9,atrio-ventricular nodal tachycardia=46;group A:septal accessory pathway+ atrio-ventricular nodal tachycardia,n=52,group B: free wall accessory pathway,n=34）.Results:HRV data（time-domain and frequency-domain） in group A 1 year after RFCA,including very low frequency（VLF）,low frequency（LF）,high frequency（HF）,R-R interval,root mean squared successive difference interval（rMSSD）,the percent of sinus cycles differing from preceding cycle by＞50 ms（PNN50） and delta VLF,delta LF,delta HF,delta rMSSD and delta PNN50 significantly decreased than that before the ***/HF,SD of all normal to normal intervals （SDNN） and SD of 5-minute average normal to normal intervals（SDANN） were not significantly changed after *** data in group B 1 year after RFCA was not significantly changed than that before the ***:RFCA operation in site of septal accessory pathway and atrio-ventricular node slow pathway can cause delayed injury of autonomic *** decrement 1 year after RFCA and persistent inappropriate sinus tachycardia post-RFCA was resulted from delayed injury of cardiac vagus nerve by radiofrequency current.

关键词： radiofrequency catheter ablation heart rate variation vagus nerve

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Nonfluoroscopic radiofrequency catheter ablation of paroxysmal supraventricular tachycardia

Nonfluoroscopic radiofrequency catheter ablation of paroxysm...

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2012年浙江省心电生理与起搏学术年会

作者： Chu Hui-min Shen Cai-jie He Bin Liu Jing Yu Yi-bo Feng Ming-jun Chen Xiao-min Department of Cardiology Ningbo First Hospital

【Objective】We reported successful radiofrequency catheter ablation (RFCA) of 51 paroxysmal supraventricular tachycardia (PSVT) without fluoroscopy guided by 3D electroanatomic mapping system (EMS) (EnSite NavX). Methods catheters position was navigated with automaticly fast mapping function of EnSite NavX mapping combined with electrophysiology study. The diagnostic catheters were introduced and positioned at the coronary sinus (CS) and ventricle apex,

关键词： 3D electroanatomic mapping system X-ray fluoroscopy radiofrequency catheter ablation Paroxysmal supraventricular tachycardia

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catheter ablation of premature ventricular complexes associated with false tendons: A case report

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World Journal of Clinical Cases 2020年第2期8卷 325-330页

作者： Ya-Bing Yang Xiao-Feng Li Ting-Ting Guo Yu-He Jia Jun Liu Min Tang Pi-Hua Fang Shu Zhang Cardiovascular Medicine Department Beijing Renhe HospitalBeijing 102600China Center for Cardiac Arrhythmia Fuwai HospitalNational Center for Cardiovascular DiseasesState Key Laboratory of ChinaChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

BACKGROUND False tendon is a common intraventricular anatomical variation. It refers to a fibroid or fibromuscular structure that exists in the ventricle besides the normal connection of papillary muscle and mitral or tricuspid valve. A large number of clinical studies have suggested that there is a significant correlation between false tendons and premature ventricular complexes. However, few studies have verified this correlation during radiofrequency catheter ablation of premature ventricular *** SUMMARY A 45-year-old male was admitted to receive radiofrequency ablation for symptomatic premature ventricular complexes. A three-dimensional model of the left ventricle was established by intracardiac echocardiography using the CartoSound^TM mapping system. In addition to the left anterior papillary muscle,the posterior papillary muscle was mapped. False tendons were found at the base of the interventricular septum, and the other end was connected to the left ventricular free wall near the apex. An irrigated touch force catheter was advanced into the left ventricle via the retrograde approach. The earliest activation site was marked at the interventricular septum attachment of the false tendons and was successfully *** This case verified that false tendons can cause premature ventricular complexes and may be cured by radiofrequency ablation guided by intracardiac echocardiography with the Carto Sound TM system.

关键词： Intracardiac echocardiography CartoSound^TM radiofrequency catheter ablation Premature ventricular complexes False tendons Case report

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