A Study On The Efficacy And Safety Of FTI Combined With VisiTag In The Catheter Ablation Of Paroxysmal Atrial Fibrillation

Background:VisiTag is a tool for recording and analyzing the effect of catheter ablation in Carto3 system,it can be real-time feedback the stability between catheter and the myocardial tissue,and according to the preoperative parameters automatically generated for each ablation point,analyzing the degree of transmural injury of different ablation points after surgery,so it is a kind of quantitative ablation procedure of atrial fibrillation A method of quantitative ablation of atrial fibrillation.FTI(Force-Time Integral)is the integral of the pressure value and ablation time of each ablation point.It has been reported that when the FTI parameter is set at 350-450 g.s in catheter ablation,which could achieve effective transmembrane injury to improve the success rate of atrial fibrillation catheter ablation,and could reduce the incidence of surgical complications,so it is an effective and safe ablation strategy.Objective: To investigate the efficacy and safety of the ablation parameter FTI combined with Visi Tag in the catheter ablation of paroxysmal atrial fibrillation.Methods: According to whether taking the use of FTI combined with VisiTag to guide the catheter ablation of paroxysmal atrial fibrillation,a total of 100 patients with paroxysmal atrial fibrillation who underwent catheter ablation were randomly divided into group A(n=50)and group B(n=50),and all the patients were admitted to Department of Arrhythmia,Affiliated Hospital of Dalian Medical University between the period from June 2015 to June 2016.The patients in group A used FTI combined with VisiTag to guide catheter ablation.The patients in group B did not use FTI combined with VisiTag to guide catheter ablation.For the two groups of 100 patientswith paroxysmal atrial fibrillation were underwent same surgical procedure by circulating pulmonary vein ablation to pulmonary vein isolation,and were completed by the same surgeon.All ablation catheters used in the procedure were contact pressure catheters,and catheter ablation of atrial fibrillation was performed under three-dimensional electroanatomical mapping system(CARTO3).The operative time,pulmonary vein ablation to electrical isolation time,X-ray exposure time,and the success rate of one-time realization of bilateral pulmonary vein ablation to the complete electrical isolation.Patients were followed up after ablation,the success rate of atrial fibrillation catheter ablation in the acute phase and long-time were compared between the two groups.The incidence of complications associated with surgery were compared between the two groups at the same time.Result: In the acute observation of catheter ablation,group A compared with group B,not only significantly reduce the entire operation time(107.4 ± 7.1 vs.143.2 ±17.0min,P<0.05),pulmonary vein ablation to pulmonary vein isolation time(35.2±5.6 vs.43.5±5.8min,P<0.05)and X-ray exposure time(2.0±1.8 vs.4.2±3.3min,P<0.05),and also could increase the success rate of single ablation to pulmonary vein isolation significantly(94% vs.80%,P <0.05).For patients with AF after catheter ablation,the success rate of acute and long-term catheter ablation in group A were significantly higher than that in group B(92.0% vs.76%,P<0.05;88% vs.72%,P<0.05).reduced the operative complications(0% vs.4%,P <0.05).The incidence of complications was significantly lower in group A than in group B(0% vs.4%,P <0.05).Conclusion: The end of atrial fibrillation catheter ablation is always to form effective and permanent transmural damage,and to improve long-term success rate after catheter ablation.For the patients with paroxysmal atrial fibrillation,using FTI combined with Visi Tag to guide the catheter ablation and more than 80% of the ablation points' FTI values were at 350 g.s-400 g.s,which could reduce the operative time and X-ray exposure time,ablation time and and also could increase the success rate of single ablation to pulmonary vein isolation significantly,reduced the incidence of complications associated with surgery.More importantly,it could improve the successrate of atrial fibrillation catheter ablation in the acute phase and long-term.So it was a safe and effective ablation strategy by using FTI combined with VisiTag to guide the catheter ablation of paroxysmal atrial fibrillation,and it had important clinical significance.