从左心室到肺静脉的电生理学突破
M Haïssaguerre1, D C Shah, P Jaïs
1Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France.
Circulation
|November 15, 2000
概括
对心房的肺静脉 (PV) 切除可以通过准特定的突破点来实现,不一定是整个PV周围. 这种方法可以有效切断电力,并减少心律失常的复发.
科学领域:
- 电子生理学 电子生理学
- 心脏病学 心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 在心房动 (AF) 中确定肺静脉 (PV) 电断的骨干切除的精确程度仍然不清楚.
- 了解发动AF的PVs的心肌延伸对于有效治疗至关重要.
研究的目的:
- 为了研究骨干切除的必要程度,从左心室电气断开肺静脉 (PVs).
- 确定在心房动患者中实现PV断开的特定消化标.
主要方法:
- 70名患者在鼻节律或心房节奏期间使用10个电极导管进行PV映射.
- 在显示最早激活 (突破) 的段落进行了停滞不前的除,以实现光伏断开连接.
- 分析光伏电位的周边分布和激活序列,指导除策略.
主要成果:
- 光伏潜力存在于光伏周边的60-88%,从突破点开始连续激活.
- 针对最早的激活部位 (突破) 在某些情况下消除了光伏潜力,而在其他情况下则需要在多个细分段进行切除.
- 每个PV的中位数为4-6个双极症被准以实现断开连接,在31名患者中出现早期复发,通常与恢复的突破部位有关.
结论:
- 在特定突破点上进行部分周边切除足以使状光伏断开连接.
- 肺静脉肌肉沿着PV外围显著延伸,但战略性切除可以实现电气隔离.
- 有效的光伏断电可以通过从左前庭准独特的突破点来实现.
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