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| 題名: | Benefits of Atrial Substrate Modification Guided by Electrogram Similarity and Phase Mapping Techniques to Eliminate Rotors and Focal Sources Versus Conventional Defragmentation in Persistent Atrial Fibrillation |
| 作者: | 黃鍔;Lin, Yenn-Jiang;Lo, Men-Tzung;Chang, Shih-Lin;Lo, Li-Wei;Hu, Yu-Feng;Chao, Tze-Fan;Chung, Fa-Po;Liao, Jo-Nan;Lin, Chin-Yu;Kuo, Huan-Yu;Chang, Yi-Chung;Lin, Chen;Tuan, Ta-Chuan;Vincent Young, Hsu-Wen;Suenari, Kazuyoshi;Dan Do, Van Buu;Raharjo, Suunu Budhi;Huang, Norden E.;Chen, Shih-Ann |
| 貢獻者: | 認知智慧與精準健康照護研究中心 |
| 關鍵詞: | ablation;atrial fibrillation;Cardiovascular;electrogram;rotor |
| 日期: | 2016-11-01 |
| 上傳時間: | 2026-04-23 14:25:30 (UTC+8) |
| 出版者: | Elsevier USA;United States: Elsevier Inc |
| 摘要: | 摘要： This prospective study compared the efficacy of atrial substrate modification guided by a nonlinear phase mapping technique with that of conventional substrate ablation. The optimal ablation strategy for persistent atrial fibrillation (AF) was unknown. In phase 1 study, we applied a cellular automation technique to simulate the electrical wave propagation to improve the phase mapping algorithm, involving analysis of high-similarity electrogram regions. In addition, we defined rotors and focal AF sources, using the physical parameters of the divergence and curvature forces. In phase 2 study, we enrolled 68 patients with persistent AF undergoing substrate modification into 2 groups, group-1 (n = 34) underwent similarity index (SI) and phase mapping techniques; group-2 (n = 34) received complex fractionated atrial electrogram ablation with commercially available software. Group-1 received real-time waveform similarity measurements in which a phase mapping algorithm was applied to localize the sources. We evaluated the single-procedure freedom from AF. In group-1, we identified an average of 2.6 ± 0.89 SI regions per chamber. These regions involved rotors and focal sources in 65% and 77% of patients in group-1, respectively. Group-1 patients had shorter ablation procedure times, higher termination rates, and significant reduction in AF recurrence compared to group-2 and a trend toward benefit for all atrial arrhythmias. Multivariate analysis showed that substrate mapping using nonlinear similarity and phase mapping was the independent predictor of freedom from AF recurrence (hazard ratio: 0.26; 95% confidence interval: 0.09 to 0.74; p = 0.01). Our study showed that for persistent AF ablation, a specified substrate modification guided by nonlinear phase mapping could eliminate localized re-entry and non-pulmonary focal sources after pulmonary vein isolation. [Display omitted]
其他題名： JACC Clin Electrophysiol
出版者： United States: Elsevier Inc
出版日期： 2016-11-01
出處： JACC. Clinical electrophysiology, 2016-11, Vol.2 (6), p.667-678
資源來源： Alma/SFX Local Collection
版權： 2016 American College of Cardiology Foundation
版權： American College of Cardiology Foundation
版權： Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
識別號： ISSN: 2405-500X
識別號： ISSN: 2405-5018
識別號： EISSN: 2405-5018
識別號： DOI: 10.1016/j.jacep.2016.08.005
識別號： PMID: 29759744 |
| 顯示於類別: | [認知智慧與精準健康照護研究中心] 期刊論文
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