Приказ основних података о дисертацији
Analiza rezultata radiofrekventne kateterske ablacije atrijalne fibrilacije vođene trodimenzionalnim elektroanatomskim maping sistemom
Results of radiofrequency catheter ablation of atrial fibrillation using three-dimensional electroanatomic mapping system
dc.contributor.advisor | Mujović, Nebojša | |
dc.contributor.other | Stanković, Goran | |
dc.contributor.other | Potpara, Tatjana | |
dc.contributor.other | Kostić, Tomislav | |
dc.creator | Marinković, Milan | |
dc.date.accessioned | 2022-12-26T12:31:24Z | |
dc.date.available | 2022-12-26T12:31:24Z | |
dc.date.issued | 2022-09-22 | |
dc.identifier.uri | https://eteze.bg.ac.rs/application/showtheses?thesesId=8911 | |
dc.identifier.uri | https://fedorabg.bg.ac.rs/fedora/get/o:27279/bdef:Content/download | |
dc.identifier.uri | https://plus.cobiss.net/cobiss/sr/sr/bib/82036745 | |
dc.identifier.uri | https://nardus.mpn.gov.rs/handle/123456789/21105 | |
dc.description.abstract | Uvod: Kateterska ablacija atrijalne fibrilacije (AF) je značajno efikasnija od antiaritmika u održavanju sinusnog ritma. Razvojem elektroanatomskih maping (EAM) sistema značajno je unapređen rezultat ablacije AF. Ciljevi: Analiza (1) izvodljivosti ablacije AF vođene EAM sistemom u našem centru i periproceduralnih komplikacija, (2) efekta ablacije AF na održavanje sinusnog ritma i kardiovaskularne (KV) događaje. Metodologija: Analizirano je 498 konsekutivnih bolesnika (životno doba 60 [IQR:52–66] god., 61.4% muškarci, 72.9% paroksizmalna AF) koji su podvrgnuti ablaciji AF uz upotrebu EAM sistema. Izvršena je široka antralna izolacija plućnih vena (sa/bez ablacije supstrata). Praćenje je vršeno 24h-Holterom nakon 1, 3, 6 meseci posle ablacije, a potom svakih 6 meseci. Registrovani su recidivi aritmije i KV događaji (kompozit: smrtnost, nefatalni moždani udar, nefatalni infarkt miokarda, veliko krvarenje i/ili srčana insuficijencija) posle ablacije. Rezultati: Ukupno je izvršena 721 procedura ablacije. Kasni recidiv aritmije je imalo 18.7% bolesnika tokom praćenja od 30 ± 17 meseci posle poslednje procedure. Nezavisni prediktori pojave kasnih recidiva su bili: pojava ranog recidiva <3 meseca (HR 6.75) i dimenzija leve pretkomore (HR 1.06 za svaki 1 mm). Stopa major komplikacija je bila 4.9%, a prediktori njihove pojave su: ishemijska bolest srca (OR 3.11) i krivulja učenja (OR 0.65 na svakih 180 izvršenih ablacija). Pojava KV događaja nakon ablacije je registrovana kod 4% bolesnika (0.28% smrtni ishod i 0.28% moždani udar). Nezavisni prediktori KV događaja bili su: kasni recidiv aritmije (HR 3.29) i veća leva pretkomora (HR 1.11 za svaki 1 mm). Zaključak: ablacija AF vođena EAM sistemima je efikasna i bezbedna terapijska opcija za održavanje sinusnog ritma. Sinusni ritam posle ablacije povezan je sa povoljnim KV ishodom. | sr |
dc.description.abstract | maintenance of sinus rhythm. Development of electroanatomic mapping (EAM) systems significantly improved the result of AF ablation. Objectives: the analysis of (1) feasibility of AF ablation guided by EAM in our centre and periprocedural complications, (2) efects of ablation on rhythm control and cardiovascular outcomes. Methods: We analyzed 498 consecutive patients (median age 60 [IQR:52–66] years, 61.4% males, 72.9% paroxysmal AF) who underwent AF ablation guided by EAM. In all patients wide antral pulmonary vein isolation (with/without substrat ablation) was completed. Follow-up consisted of 24h/Holter-recordings at 1, 3, 6 months after ablation, and thereafter every 6 months. We registered all the arrhythmia recurrences and CV events (composit of fatal outcome, nonfatal stroke, nonfatal myocardial infarction, major bleeding and/or heart failure) after ablation. Results: A total of 721 ablation procedure were performed. The late arrhytmia recurrence was detected in 18.7% of patients during the follow-up of 30 ± 17 months after last procedure. Multivariate risk factors for the late recurrence are: the early recurrence within the 3 months post-ablation (HR 6.75) and left atrial diameter (HR 1.06 for each 1 mm). The rate of major complications was 4.9%, and risk factors for their occurrence are: ischemic heart disease (OR 3.11) and learning curve (OR 0.65 for each 180 consecutive procedures). The CV events post-ablation was noted in 4% of patients (lethal outcome 0.28%, nonfatal stroke 0.28%). Multivariate risk factors for CV events are: the late arrhythmia recurrence (HR 3.29) and dilated left atrium (HR 1.11 for each 1 mm). Conclusion: AF ablation guided by an EAM system is efficient and safe treatment option for maintenance of sinus rhythm. A sinus rhythm after ablation is related to better CV outcome(s). | en |
dc.format | application/pdf | |
dc.language | sr | |
dc.publisher | Универзитет у Београду, Медицински факултет | sr |
dc.rights | openAccess | en |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | |
dc.source | Универзитет у Београду | sr |
dc.subject | Atrijalna fibrilacija | sr |
dc.subject | Atrial fibrillation | en |
dc.subject | 3D maping sistem | sr |
dc.subject | kateterska ablacija | sr |
dc.subject | izolacija plućnih vena | sr |
dc.subject | recidivi aritmije | sr |
dc.subject | komplikacije | sr |
dc.subject | kvalitet života | sr |
dc.subject | funkcionalni status | sr |
dc.subject | 3D mapping system | en |
dc.subject | catheter ablation | en |
dc.subject | pulmonary vein isolation | en |
dc.subject | arrhythmia reccurrence | en |
dc.subject | complications | en |
dc.subject | quality of life | en |
dc.subject | functional capacity | en |
dc.title | Analiza rezultata radiofrekventne kateterske ablacije atrijalne fibrilacije vođene trodimenzionalnim elektroanatomskim maping sistemom | sr |
dc.title.alternative | Results of radiofrequency catheter ablation of atrial fibrillation using three-dimensional electroanatomic mapping system | en |
dc.type | doctoralThesis | |
dc.rights.license | BY | |
dc.identifier.fulltext | http://nardus.mpn.gov.rs/bitstream/id/148994/Disertacija_13033.pdf | |
dc.identifier.fulltext | http://nardus.mpn.gov.rs/bitstream/id/152613/Referat.pdf | |
dc.identifier.rcub | https://hdl.handle.net/21.15107/rcub_nardus_21105 |