Статья
Факторы, ассоциированные с эффективностью радиочастотной катетерной аблации фибрилляции предсердий: мнение специалистов, применяющих технологию «индекс аблации»
В настоящем документе изложены обзор современных проблем и тенденций в катетерном лечении фибрилляции предсердий, анализ мнений специалистов об аспектах и параметрах радиочастотной аблации, полученных в ходе электронного опроса, а также подходов к повышению эффективности и безопасности радиочастотной катетерной аблации фибрилляции предсердий.
1. Shkolnikova MA, Jdanov DA, Ildarova RA, et al. Atrial fibrillation among Russian men and women aged 55 years and older: prevalence, mortality, and associations with biomarkers in a population-based study. J Geriatr Cardiol. 2020;17(2): 74-84. DOI: 10.11909/j.issn.1671- 5411.2020.02.002.
2. Odutayo A, Wong CX, Hsiao AJ, et al. Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis. BMJ. 2016; 354: i4482. DOI: 10.1136/bmj.i4482.
3. Morillo CA, Verma A, Connolly SJ, et al. Radiofrequency Ablation vs Antiarrhythmic Drugs as First-Line Treatment of Paroxysmal Atrial Fibrillation (RAAFT-2) A Randomized Trial. JAMA. 2014 Feb 19;311(7): 692-700. DOI: 10.1001/jama.2014.467.
4. Packer DL, Kowal RC, Wheelan KR, et al. Cryoballoon Ablation of Pulmonary Veins for Paroxysmal Atrial Fibrillation: First Results of the North American Arctic Front (STOP AF) Pivotal Trial. J Am Coll Cardiol. 2013 Apr 23;61(16): 1713-23. DOI: 10.1016/j.jacc.2012.11.064.
5. Marrouche NF, Brachmann J, Andresen D, et al. Catheter Ablation for Atrial Fibrillation with Heart Failure. New England Journal of Medicine. 2018;378(5): 417-27. DOI: 10.1056/NEJMoa1707855.
6. Гасымова НЗ, Михайлов ЕН, Оршанская ВС и др. Обратное ремоделирование сердца после катетерной аблации фибрилляции предсердий у пациентов с сердечной недостаточностью и низкой фракцией выброса левого желудочка. Кардиология. 2019;59(8S): 37-43. DOI: 10.18087/cardio.2671.
7. Hindricks G, Camm J, Merkely B, et al. The EHRA White Book 2017. The current status of cardiac electrophysiology in ESC member countries. Available from URL https://www.escardio.org/static_file/Escardio/Subspecialty/EHRA/Publications/Documents/2017/ehra-whitebook-2017.pdf.
8. Shah RU, Freeman JV, Shilane D, et al. Complications, Rehospitalizations, and Repeat Procedures After Catheter Ablation for Atrial Fibrillation. J Am Coll Cardiol. 2012; 59(2): 143-149. DOI: 10.1016/j.jacc.2011.08.068.
9. Cheung JW, Yeo I, Cheng E, et al. Inpatient hospital procedural volume and outcomes following catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2020; 31(7):1-32 DOI: 10.1111/jce.14584.
10. Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2017;14(10):e275-444. DOI: 10.1093/europace/eux274.
11. Pecha S, Ghandili S, Hakmi S, et al. Predictors of Long-term Success After Concomitant Surgical Ablation for Atrial Fibrillation. Semin Thorac Cardiovasc Surg. 2017;29(3): 294-298. DOI: 10.1053/j.semtcvs.2017.08.01.
12. Михайлов ЕН, Гасымова НЗ, Байрамова СА и др. Клиническая характеристика пациентов и результаты катетерной аблации фибрилляции предсердий в российской популяции: субанализ европейского регистра 2012-2016гг. Российский кардиологический журнал. 2018;(7):7-15. DOI:10.15829/1560-4071-2018-7-7-15.
13. Pathak RK, Middeldorp ME, Lau DH, et al. Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARREST-AF cohort study. J Am Coll Cardiol. 2014;64(21): 2222-2231. DOI: 10.1016/j.jacc.2014.09.028.
14. Dimitri H, Ng M, Brooks AG, et al. Atrial remodeling in obstructive sleep apnea: implications for atrial fibrillation. Heart Rhythm. 2012;9(3): 321-327. DOI: 10.1016/j. hrthm.2011.10.017.
15. Li L, Wang Z-W, Jie Li, et al. Efficacy of catheter ablation of atrial fibrillation in patients with obstructive sleep apnoea with and without continuous positive airway pressure treatment: a meta-analysis of observational studies. Europace. 2014; 16(9):1309-1314. DOI: 10.1093/europace/euu066.
16. Santoro F, Di Biase L, Trivedi C, et al. Impact of Uncontrolled Hypertension on Atrial Fibrillation Ablation Outcome. JACC: Clinical Electrophysiology. 2015;1(3): 164-173. DOI: 10.1016/j.jacep.2015.04.002.
17. Qiao Y, Shi R, Hou B, et al. Impact of alcohol consumption on substrate remodeling and ablation outcome of paroxysmal atrial fibrillation. J Am Heart Assoc. 2015;4(11): e002349. DOI: 10.1161/JAHA.115.002349.
18. Mikhaylov EN, Orshanskaya VS, Lebedev AD, Szili-Torok T, Lebedev DS. Catheter ablation of paroxysmal atrial fibrillation in patients with previous amiodarone-induced hyperthyroidism: a case-control study. Journal of Cardiovascular Electrophysiology. 2013;24(8): 888-893. DOI: 10.1111/jce.12140.
19. Winkle RA, Jarman JWE, Mead H, et al. Predicting Atrial Fibrillation Ablation Outcome: The CAAP-AF Score. Heart Rhythm. 2016;13(11): 2119-2125. DOI: 10.1016/j.hrthm.2016.07.018.
20. Kornej J, Hindricks G, Arya A, et al. The APPLE Score - A Novel Score for the Prediction of Rhythm Outcomes after Repeat Catheter Ablation of Atrial Fibrillation. PLoS One. 2017; 12(1): e0169933. DOI: 10.1371/journal. pone.0169933.
21. Jud FN, Obeid S, Duru F, Haegeli LM. A novel score in the prediction of rhythm outcome after ablation of atrial fibrillation: The SUCCESS score. Anatol J Cardiol. 2019; 21(3): 142-149. DOI: 10.14744/AnatolJCardiol.2018.76570.
22. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37: 2893-962. DOI: 10.1093/eurheartj/ehw210.
23. Ревишвили АШ, Шляхто ЕВ, Сулимов ВА и др. Клинические рекомендации: «Диагностика и лечение фибрилляции предсердий». Москва, 2017; 211 с.
24. Glover BM, Hong KL, Dagres N, et al. Impact of Body Mass Index on the Outcome of Catheter Ablation of Atrial Fibrillation. Heart. 2019;105(3): 244-250. DOI: 10.1136/ heartjnl-2018-313490.
25. Gianni C, Perez MV, Al-Ahmad A, Natale A. How to perform pulmonary vein antral isolation for atrial fibrillation. In Hands-on ablation experts’ approaches second edition (Ed. Al-Ahmad A, Callans DJ, Hsia HH, Natale A, Oseroff O, Wang PJ). Minneapolis 2017: 135-145 ISBN 978-1-942909-17-0.
26. Duytschaever M, O’Neill M, Martinek M. Increasing the Single-Procedure Success Rate of Pulmonary Vein Isolation. Arrhythmia & Electrophysiology Review. 2017;6(4): 217-221. DOI: 10.15420/aer.2017.38/1.
27. Della Rocca DG, Di Biase L, Tarantino N, et al. Single procedure success rate of radiofrequency catheter ablation of persistent atrial fibrillation results from a prospective, multicentre, observational registry. Journal of the American College of Cardiology. 2020 75(11): 509. DOI: 10.1016/S0735-1097(20)31136-0.
28. Mikhaylov EN, Lebedev DS, Pokushalov EA, et al. Outcomes of cryoballoon ablation in high- and low-volume atrial fibrillation ablation centres: a Russian pilot survey. BioMed Research International. 2015;2015: 591603. DOI: 10.1155/2015/591603.
29. Joshi S, Choi AG, Kamath GS, et al. Prevalence, predictors, and prognosis of atrial fibrillation early after pulmonary vein isolation: findings from 3 months of continuous automatic ECG loop recordings. J Cardiovasc Electrophysiol. 2009;20(10): 1089-1094. DOI: 10.1111/j.1540- 8167.2009.01506.x.
30. Andrade JG, Khairy P, Verma A, et al. Early recurrence of atrial tachyarrhythmias following radiofrequency catheter ablation of atrial fibrillation. Pacing Clin Electrophysiol. 2012;35: 106-116 (2012). DOI: 10.1111/j.1540- 8159.2011.03256.x.
31. Andrade JG, Khairy P, Macle L, et al. Incidence and significance of early recurrences of atrial fibrillation after cryoballoon ablation: insights from the multicenter Sustained Treatment of Paroxysmal Atrial Fibrillation (STOP AF) Trial. Circ Arrhythm Electrophysiol. 2014;7(1):69-75. DOI: 10.1161/CIRCEP.113.000586.
32. Andrade JG, Khairy P, Macle L, et al. Incidence and significance of early recurrences associated with different ablation strategies for AF: a STAR-AF substudy. J Cardiovasc Electrophysiol 2012;23(12):1295-1301. DOI: 10.1111/j.1540-8167.2012.02399.x.
33. Liang JJ, Dixit S. Early Recurrences During the Blanking Period after Atrial Fibrillation Ablation. J Atr Fibrillation. 2018;10(5): 1726. DOI: 10.4022/jafib.1726.
34. Liang JJ, Dixit S, Santangeli P. Mechanisms and clinical significance of early recurrences of atrial arrhythmias after catheter ablation for atrial fibrillation. World J Car-diol. 2016;8(11): 638-646. DOI: 10.4330/wjc.v8.i11.638.
35. Коробченко ЛЕ, Байрамова СА., Харац ВЕ и др. Динамика антиаритмической терапии после катетерной аблации фибрилляции предсердий: данные российской клинической практики в регистре ESC-EHRA. Российский кардиологический журнал. 2020;25(5):3874. DOI:10.15829/1560-4071- 2020- 3874]doi:10.15829/1560-4071-2020-3874.
36. Kaitani K, Inoue K, Kobori A, et al. Efficacy of Antiarrhythmic Drugs Short-Term Use After Catheter Ablation for Atrial Fibrillation (EAST-AF) trial. Eur Heart J. 2016;37(7): 610-8. DOI: 10.1093/eurheartj/ehv501.
37. Leong-Sit P, Roux J-F, Zado E, et al. Antiarrhythmics After Ablation of Atrial Fibrillation (5A Study): Six-Month Follow-Up Study Circ Arrhythm Electrophysiol. 2011;4(1): 11-4. DOI: 10.1161/CIRCEP.110.955393.
38. Duytschaever M, Demolder A, Phlips T, et al. PulmOnary Vein Isolation With vs. Without Continued Antiarrhythmic Drug trEatment in Subjects With Recurrent Atrial Fibrillation (POWDER AF): Results From a Multicentre Randomized Trial. Eur Heart J. 2018;39(16): 1429-1437. DOI: 10.1093/eurheartj/ehx666.
39. Yoo Ri Kim 1, Gi-Byoung Nam 2, Seungbong Han, et al. Effect of Short-Term Steroid Therapy on Early Recurrence During the Blanking Period After Catheter Ablation of Atrial Fibrillation. Circ Arrhythm Electrophysiol. 2015;8(6): 1366-72. DOI: 10.1161/CIRCEP.115.002957.
40. Imazio M, Brucato A, Ferrazzi P, et al. Colchicine reduces postoperative atrial fibrillation: results of the Colchicine for the Prevention of the Postpericardiotomy Syndrome (COPPS) atrial fibrillation substudy. Circulation. 2011;124(21): 2290-2295. DOI: 10.1161/CIRCULATIONAHA.
41. Deftereos S, Giannopoulos G, Kossyvakis C, et al. Colchicine for prevention of early atrial fibrillation recurrence after pulmonary vein isolation: a randomized controlled study. J Am Coll Cardiol. 2012;60(18): 1790-1796. DOI: 10.1016/j.jacc.2012.07.031.
42. Deftereos S, Giannopoulos G, Efremidis M, et al. Colchicine for prevention of atrial fibrillation recurrence after pulmonary vein isolation: mid-term efficacy and effect on quality of life. Heart Rhythm. 2014;11(4): 620-628. DOI: 10.1016/j.hrthm.2014.02.002.
43. Anné W, Willems R, Van der Merwe N, et al. Atrial fibrillation after radiofrequency ablation of atrial flutter: preventive effect of angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, and diuretics. Heart. 2004; 90(9): 1025-1030. DOI: 10.1136/hrt.2003.023069.
44. Whitaker J, Fish J, Harrison J, et al. MD. Lesion index-guided ablation facilitates continuous, transmural, and durable lesions in a porcine recovery model. Circ Arrhythm Electrophysiol. 2018;11: e005892. DOI: 10.1161/ CIRCEP.117.005892.
45. Chae S, Oral H, Good E, et al. Atrial tachycardia after circumferential pulmonary vein ablation of atrial fibrillation: mechanistic insights, results of catheter ablation, and risk factors for recurrence. J Am Coll Cardiol. 2007;50: 1781-1787. DOI: 10.1016/j.jacc.2007.07.044.
46. Kimura M, Sasaki S, Owada S, et al. Comparison of lesion formation between contact force‐guided and non-guided circumferential pulmonary vein isolation: a prospective, randomized study. Heart Rhythm. 2014;11: 984-91. DOI: 10.1016/j.hrthm.2014.03.019.
47. Andrade JG, Monir G, Pollak SJ, et al. Pulmonary vein isolation using “contact force” ablation: the effect on dormant conduction and long‐term freedom from recurrent atrial fibrillation - a prospective study. Heart Rhythm. 2014;11: 1919-24. DOI: 10.1016/j.hrthm.2014.07.033.
48. Мамчур СЕ, Хоменко ЕА, Горбунова ЕВ и др. Качество контакта аблационного электрода с тканью при катетерной аблации фибрилляции предсердий в зависимости от опыта электрофизиолога. Вестник аритмологии. 2015;80:5-10.
49. Neuzil P, Reddy VY, Kautzner J, et al. Electrical Reconnection After Pulmonary Vein Isolation Is Contingent on Contact Force During Initial Treatment: Results From the EFFICAS I Study. Circ Arrhythm Electrophysiol. 2013;6(2): 327-33. DOI: 10.1161/CIRCEP.113.000374.
50. Kautzner J, Neuzil P, Lambert H, et al. EFFICAS II: Optimization of Catheter Contact Force Improves Outcome of Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation. Europace. 2015;17(8): 1229-35. DOI: 10.1093/europace/euv057.
51. Black-Maier E, Pokorney SD, Barnett AS. Risk of Atrioesophageal Fistula Formation With Contact Force-Sensing Catheters. Heart Rhythm. 2017 Sep;14(9):1328-1333. DOI: 10.1016/j.hrthm.2017.04.024.
52. Pranata R, Vania R, Huang I. Ablation-index guided versus conventional contact-force guided ablation in pulmonary vein isolation - systematic review and meta-analysis. Indian Pacing Electrophysiol J. 2019;19(4): 155-160. DOI: 10.1016/j.ipej.2019.05.001.
53. Hussein A, Das M, Riva S, et al. Use of ablation index-guided ablation results in high rates of durable pulmonary vein isolation and freedom from arrhythmia in persistent atrial fibrillation patients. Circulation: Arrhythmia and Electrophysiology. 2018;11: e006576. DOI: 10.1161/ CIRCEP.118.006576.
54. Phlips T, Taghji P, El Haddad M, et al. Improving procedural and one-year outcome after contact force-guided pulmonary vein isolation: the role of interlesion distance, ablation index, and contact force variability in the ‘CLOSE’-protocol. Europace. 2018;20(FI_3): 419-427. DOI: 10.1093/europace/eux376.
55. Lee SR, Choi EK, Lee EJ, et al. Efficacy of the optimal ablation index-targeted strategy for pulmonary vein isolation in patients with atrial fibrillation: the OPTIMUM study results. J Interv Card Electrophysiol. 2019;55(2): 171-181. DOI: 10.1007/s10840-019-00565-4.
56. Das M, Loveday JJ, Wynn GJ, et al. Ablation index, a novel marker of ablation lesion quality: prediction of pulmonary vein reconnection at repeat electrophysiology study and regional differences in target values. Europace. 2017;19: 775-83. DOI: 10.1093/europace/euw105.
57. Taghji P, El Haddad M, Phlips T, et al. Evaluation of a strategy aiming to enclose the pulmonary veins with contiguous and optimized radiofrequency lesions in paroxysmal atrial fibrillation: a pilot study. JACC: Clinical Electrophysiology. 2018;4(1): 99-108. DOI: 10.1016/j.jacep.2017.06.023.
58. Gasimova NZ, Kolunin GV, Artyukhina EA, et al. Prospective Registry of Atrial Fibrillation Ablation with the Ablation Index Technology: Rationale and Study Design. Cardiology. 2020; [article in press].
59. Valles E, Fan R, Roux JF, et al. Localization of Atrial Fibrillation Triggers in Patients Undergoing Pulmonary Vein Isolation: Importance of the Carina Region. J Am Coll Cardiol. 2008;52(17): 1413-20. DOI: 10.1016/j. jacc.2008.07.025.
60. Kumagai K, Naito S, Nakamura K, et al. ATP-induced Dormant Pulmonary Veins Originating From the Carina Region After Circumferential Pulmonary Vein Isolation of Atrial Fibrillation. J Cardiovasc Electrophysiol. 2010;21(5):494-500. DOI: 10.1111/j.1540- 8167.2009.01667.x.
61. Hussein A, Das M, Riva S, et al. Use of Ablation Index-Guided Ablation Results in High Rates of Durable Pulmonary Vein Isolation and Freedom From Arrhythmia in Persistent Atrial Fibrillation Patients The PRAISE Study Results. Circ Arrhythm Electrophysiol. 2018;11: e006576. DOI: 10.1161/CIRCEP.118.006576.
62. Squara F, Liuba I, Chik W, et al. Electrical Connection Between Ipsilateral Pulmonary Veins: Prevalence and Implications for Ablation and Adenosine Testing. Heart Rhythm. 2015 Feb;12(2):275-82. DOI: 10.1016/j. hrthm.2014.11.003.
63. Casaclang-Verzosa G, Gersh BJ, Tsang TS. Structural and functional remodeling of the left atrium: Clinical and therapeutic implications for atrial fibrillation. Journal of the American College of Cardiology. 2008;51: 1-11. DOI: 10.1016/j.jacc.2007.09.026.
64. Platonov PG, Mitrofanova LB, Orshanskaya VS, Ho SY. Structural Abnormalities in Atrial Walls Are Associated With Presence and Persistency of Atrial Fibrillation But Not With Age. J Am Coll Cardiol. 2011: 2225-32. DOI: 10.1016/j.jacc.2011.05.061.
65. Akoum N, Daccarett M, Mcgann C, et al. Atrial Fibrosis Helps Select the Appropriate Patient and Strategy in Catheter Ablation of Atrial Fibrillation. A DE-MRI Guided Approach. J Cardiovasc Electrophysiol. 2011; 22(1): 16- 22. DOI: 10.1111/j.1540-8167.2010.01876.x.
66. Оршанская ВС, Каменев АВ, Белякова ЛА и др. Электроанатомический субстрат левого предсердия и его прогностическая ценность при определении риска рецидива фибрилляции предсердий после циркулярной изоляции легочных вен. Результаты проспективного обсервационного исследования. Российский кардиологический журнал. 2017;8(148): 82-89. DOI: 10.15829/1560-4071-2017-8-82-89.
67. Verma A, Jiang C-Y, Betts TR, et al. Approaches to Catheter Ablation for Persistent Atrial Fibrillation. N Engl J Med. 2015;372: 1812-1822 DOI: 10.1056/NEJMoa1408288.
68. Mikhaylov E, Gureev S, Szili-Torok T, Lebedev D. Additional left atrial septal line does not improve outcome of patients undergoing ablation for long-standing persistent atrial fibrillation. Acta Cardiologica. 2010; 65(2): 153-160. DOI: 10.2143/AC.65.2.2047048.
69. Kircher S, Arya A, Altmann D, et al. Individually tailored vs. standardized substrate modification during radiofrequency catheter ablation for atrial fibrillation: a randomized study. Europace. 2017;20(11):1766-1775. DOI:10.1093/europace/eux310.
70. Vijayaraman P, Netrebko P, Geyfman V, et al. Esophageal Fistula Formation Despite Esophageal Monitoring and Low-Power Radiofrequency Catheter Ablation for Atrial Fibrillation. Circ Arrhythmia Electrophysiol. 2009;2: e31-e33. DOI: 10.1161/CIRCEP.109.883694.
71. Kuwahara T, Takahashi A, Okubo K, et al. Oesophageal cooling with ice water does not reduce the incidence of oesophageal lesions complicating catheter ablation of atrial fibrillation: randomized controlled study. Europace. 2014;16(6): 834-839. DOI: 10.1093/europace/eut368.
72. Koruth JS, Reddy VY, Miller MA, et al. Mechanical esophageal displacement during catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2012;23(2):147- 154. DOI: 10.1111/j.1540-8167.2011.02162.x.
73. Letsas KP, Georgopoulos S, Efremidis M, et al. Adenosine-guided radiofrequency catheter ablation of atrial fibrillation: a metaanalysis of randomized control trials. J Arrhythm. 2017;33: 247-55.
74. Jiang К, Chen M, Yang B, et al. Intraprocedural endpoints to predict durable pulmonary vein isolation: a randomized trial of four post-ablation techniques. Europace. 2019; 1-9 DOI :10.1093/europace/euz301.
75. Di Biase L, Conti S, Mohanty P, et al. General Anesthesia Reduces the Prevalence of Pulmonary Vein Reconnection During Repeat Ablation When Compared With Conscious Sedation: Results From a Randomized Study. Heart Rhythm. 2011;8(3): 368-72. DOI: 10.1016/j. hrthm.2010.10.043.
76. Di Biase L, Saenz LS, Burkhardt DJ, et al. Esophageal Capsule Endoscopy After Radiofrequency Catheter Ablation for Atrial Fibrillation: Documented Higher Risk of Luminal Esophageal Damage With General Anesthesia as Compared With Conscious Sedation. Circ Arrhythm Electrophysiol. 2009;2(2): 108-12. DOI: 10.1161/CIRCEP.108.815266.
77. Cappato R, Calkins H, Chen SA, et al. Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circulation. 2005;111(9): 1100-5. DOI: 10.1161/01.CIR.0000157153.30978.67.
78. Sairaku A, Yoshida Y, Nakano Y, et al. Who is the operator, that is the question: a multicentre study of catheter ablation of atrial fibrillation? Europace. 2016;18(9):1352- 6. DOI: 10.1093/europace/euv424.
79. Solimene F, Lepillier A, De Ruvo E, et al. Reproducibility of acute pulmonary vein isolation guided by the ablation index. Pacing Clin Electrophysiol. 2019;42: 874- 881. DOI: 10.1111/pace.13710.
80. Duytschaever M, Vijgen J, De Potter T, et al. Repro-ducibility and acute efficacy of a standardized approach to isolate the pulmonary veins: results from multicenter VISTAX study. European Heart Journal. 2018, ehy566. P6227. DOI: 10.1093/eurheartj/ehy566.P6227.
81. Stabile G, Lepillier A, De Ruvo E, et al.. Reproducibility of pulmonary vein isolation guided by the ablation index: 1‐year outcome of the AIR registry. J Cardiovasc Electrophysiol. 2020; 1-8. DOI: 10.1111/jce.14531.