温度と病理生理学的効果の相関は,AV接合の放射性キャセターアブレーション中に発生する
S Nath1, J P DiMarco, J P Mounsey
1Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, USA.
Circulation
|September 1, 1995
まとめ
AV交差点の無線周波数アブレーションは,加速された交差点リズムとAV結節ブロックを誘発する可能性があります. 成功した切除部位は,これらのリズムが急速に発生し,特定の温度でブロックすることが特徴です.
科学分野:
- 電気生理学 電気生理学
- 心血管医学 心血管医学
背景:
- 加速された交差点のリズムがしばしば,AV交差点の無線周波数 (RF) 消去の間にAV結節ブロックに先行する.
- これらのイベントを誘発するための正確なタイミングと温度の値は,まだ不完全です.
研究 の 目的:
- AV交差点のRFアブレーション中に加速された交差点リズムとAV結節ブロックを誘導するための時間経過と温度要件を特徴づける.
主な方法:
- 19人の患者は,50Wまでの増量功率タイトルのサーミスターカテーテルを使用してRFアブレーションを受けた.
- RFアプリケーションは9秒間提供され,電力は5Wのインクリメントで増加しました.
- 成功したアプリケーションは,AVノードルブロックが発生するか,電力がさらに増加するまで,観測された電力レベルでRFを配信することを含む.
主要な成果:
- RFアブレーションは,すべての19人の患者で成功し,永久的なAVノードルブロックのために必要な1回のアプリケーションの中央値でした.
- 加速した交差点のリズムは,成功の89%の試みで発生し,平均発症時間は1.8秒でした.
- AVノードルブロックは,成功したアプリケーション (19.6秒) で,失敗したアプリケーション (36.8秒) よりも,著しく速く現れました.
- 加速された交差点リズム (51°C) に対するキャセーター先の温度は,AVノードルブロック (58°C) よりも低かった.
- 永久的なAV結節ブロックには,平均気温が約60°Cである必要があります.
結論:
- 加速された結節リズム (5秒以内) とAV結節ブロック (30秒以内) の急速な発症は,成功したアブレーション標的を示します.
- 加速された交差点リズムとAV結節ブロックは,どちらも非常に温度に依存する現象です.
- 加速された交差点リズムと比較して,AVノードルブロックを誘発するには,より高い温度が必要です.
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