複雑な電図によって導かれた慢性心房細動の放射線周波数カテーテルアブレーション
Hakan Oral1, Aman Chugh, Eric Good
1Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, USA. oralh@umich.edu
Circulation
|May 16, 2007
まとめ
慢性心房細動 (AF) のための放射性アブレーションは,短期的にわずかな成功を収め,多くの場合,患者の40%以上で2度目の処置を必要とします. 再発性心拍不良は,肺静脈活動とマクロエントラント回路と関連しています.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 医療機器 医療機器について
背景:
- 複合的な分断型心房電図 (CFAE) によって導かれた放射線周波数カテーテルアブレーションは,心房動 (AF) に対して有望であることが示されています.
- 以前の研究では,慢性AFの患者数が限られていた.
研究 の 目的:
- 慢性AFの患者におけるCFAEガイドによる放射線周波数カテーテルアブレーションの有効性を評価する.
- 消去後の再発性心房不律症のメカニズムを特定する.
主な方法:
- 慢性AFの患者100人は,左心房の様々な領域と冠動脈鼻腔のCFAEを標的とした放射線周波数アブレーションを受けた.
- 消去の成功は,AFの終結またはすべての特定されたCFAEsの除去によって定義されました.
- フォローアップにはリズムモニタリングと抗リズム薬の必要性の評価が含まれていました.
主要な成果:
- 1回の切除の後,33%の患者が抗不律薬なしで鼻腔リズムを維持しました.
- 患者の44%で2度目のアブレーションが必要になった.
- 長期フォローアップでは (13+/-7ヶ月前のアブレーション後) 57%の患者が抗不律薬なしで鼻腔リズムを保持していました.
結論:
- CFAEによる誘導放射性アブレーションは,慢性AFの短期的な有効性は低く,しばしば2回目の処置が必要になります.
- 肺静脈の急速な活動と複数のマクロレントラント回路は,再発性心房不律の一般的なメカニズムとして特定されています.
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