王禹川,黄波,李康,盛琴慧,陈尔冬,贺鹏康,褚松筠,蒋捷,丁燕生,周菁

• 1:北京大学第一医院老年科
• 2:北京大学第一医院心内科

摘要(Abstract)：

目的 确定与消融损伤指数（AI）值对应的时间-压力积分（FTI）值。方法 对北京大学第一医院2020年7—9月40例首次接受环肺静脉电隔离的心房颤动（AF）患者消融数据进行分析。根据消融时间、导管-组织接触力（CF）和消融功率对消融损伤点分组，构建每组FTI预测AI的受试者工作特征（R OC）曲线。以ROC曲线下面积0.9为界值，对ROC曲线下面积≥0.9且每组消融损伤点数≥20的亚组数据进行分析并计算不同分组中与目标A I值相对应的FTI切点值。结果 40例AF患者中阵发性AF31例（77.5%），男28例（70.0%），平均年龄（67.1±5.4）岁。在剔除部分不满足入选条件的消融损伤点后，共纳入2 747个消融损伤点，分为75个亚组。因进一步剔除不满足ROC曲线下面积≥0.9亚组的相关性数据，且考虑到亚组消融损伤点数过少会减弱数据分析的可信度，再将不足20个消融损伤点的亚组剔除，最终分析1 948个消融损伤点、32个亚组。以左心房后壁线AI目标值400为例，消融功率25 W,CF在6～10 g、11～15 g、16～20 g和21～25 g时，FTI切点值分别为278 gs、275 gs、316 gs和348 gs；消融功率30 W,CF在6～10 g、11～15 g、16～20 g、21～25 g时，FTI切点值分别为183 gs、206 gs、235 gs和243 gs。对数据进一步分析后发现，在相同AI目标值和同一输出功率下，CF每增加5 g，对应的FTI目标值会增加约10%。如目标AI为400和输出功率为30 W时，11～15 g组FTI目标值较6～10 g组FTI目标值提高约10%，而16～20 g组FTI目标值较11～15 g组FTI目标值提高约10%。结论 FTI值与AI值存在对应关系，但不同消融时间和CF对应的相同FTI值不具备等效性。

关键词(KeyWords)： 心房颤动;环肺静脉电隔离;消融损伤指数;时间-压力积分

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王禹川,黄波,李康,盛琴慧,陈尔冬,贺鹏康,褚松筠,蒋捷,丁燕生,周菁

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