vestarВестник аритмологииJournal of Arrhythmology1561-86412658-7327НАО «Инкарт»10.35336/VA-2021-1-33-37vestar-908Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESРоль высокоплотного картирования в лечении фибрилляции предсердийThe role of high-density mapping in atrial fibrillation ablationДедухЕ. В.DedukhE. V.

Елизавета Викторовна Дедух

Москва

Moscow

lizavettta11@mail.ruАртюхинаЕ. А.ArtyukhinaE. A.

Москва

Moscow

ФГБУ «НМИЦ хирургии им. А.В.Вишневского» Минздрава РоссииРоссияFSBI “Vishnevsky NMRC of surgery”, Russian FederationRussian Federation2021300420212813337Copyright © Дедух Е.В., Артюхина Е.А., 20212021Дедух Е.В., Артюхина Е.А.Dedukh E.V., Artyukhina E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestar.elpub.ru/jour/article/view/908Цель исследования

Цель исследования. Определить роль распространенности зон низкоамплитудной активности в возникновении рецидива аритмии после интервенционного лечения фибрилляции предсердий (ФП).

Материал и методы исследования. Всего включено в исследование 38 пациентов с пароксизмальной (52,6%) и персистирующей (47,4%) ФП, которым выполнено интервенционное лечение ФП с использованием высокоплотного электроанатомического картирования (не менее 10000 EGM точек), все пациенты сравнимы по клинико-демографическим показателям. Анализ электроанатомических карт левого предсердия (ЛП) проводился после завершения процедуры аблации. Оценка низковольтажных зон проводилась вручную с измерением их площади. Далее проводилось суммирование площади всех областей низкоамплитудной активности, затем полученную величину выражали как процент от общей площади поверхности ЛП.

Результаты

Результаты. Средний срок наблюдения 12,8±3,2 месяцев. По результатам анализа данных эндокардиального картирования все пациенты были разделены на 2 группы согласно распространенности областей низковольтажной активности в ЛП. В первую группу были включены пациенты с площадью зон низкоамплитудной активности менее 5% от общей площади ЛП, во вторую с площадью зон низкоамплитудной активности более 5% от общей площади ЛП. У пациентов первой группы был значительно меньший объем ЛП по сравнению с пациентами из второй группы, со средними значениями 119,87±16,35 мл и 154,57±33,23 мл соответственно (p=0,007). В первой группе пациентов у одного зафиксирован рецидив ФП после катетерного лечения, во второй группе у 5 пациентов.

Заключение

Заключение. Распространенные зоны низкоамплитудной активности в левом предсердии, обнаруженные при высокоплотном электроанатомическом картировании перед процедурой катетерного лечения фибрилляции предсердий, являются предиктором рецидивирования аритмии после интервенционного лечения.

Aims

Aims. To determine the role of the prevalence of low-voltage areas in the occurrence of arrhythmia recurrence after interventional treatment of atrial fibrillation (AF).

Methods

Methods. The study included 38 patients with paroxysmal (52.6%) and persistent (47.4%) forms of AF who underwent interventional treatment of AF using high-density electroanatomical mapping (at least 10,000 EGM points). Analysis of electroanatomical maps was performed after the completion of the ablation procedure. The area of the low-voltage zones was measured manually. Then, the areas of all regions of low-voltage activity were summed up; the resulting value was expressed as a percentage of the total surface area of the left atrium (LA).

Results

Results. The observation period was 12.8±3.2 months. Based on the results of endocardial mapping, all patients were divided into 2 groups according to the prevalence of low-voltage areas in the LA. The first group included patients with an area of low-voltage zones less than 5% of the total surface of the left atrium, and the second with an area of low-voltage areas of more than 5% of the total surface of the left atrium. The patients of the first group had a lower LA volume compared to patients from the second group, with mean values of 119.87±16.35 ml and 154.57±33.23 ml, respectively (p=0.007). In the first group, AF recurrence was recorded in one patient after catheter treatment, in the second group in 5 patients.

Conclusion

Conclusion. Common areas of low-voltage activity in the left atrium, detected by high-density mapping before the procedure for catheter treatment of AF, are a predictor of arrhythmia recurrence after interventional treatment.

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The authors declare that there are no conflicts of interest present.