肺静脉隔离是否需要治疗心房动?
Giuseppe Stabile1, Pietro Turco, Vincenzo La Rocca
1Laboratorio di Elettrofisiologia, Casa di Cura San Michele, Via Appia 178, 81024 Maddaloni, Italia. gmrstabile@tin.it
Circulation
|August 6, 2003
概括
肺静脉隔离对于治愈心房动 (AF) 并非必不可少. 解剖导管切除在80%以上的患者中成功预防了AF,这表明纯解剖方法是有效的.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 肺静脉 (PVs) 是心房动 (AF) 的关键触发者和延续者.
- 调查光伏电隔离对于AF治愈的必要性对于改进切除策略至关重要.
研究的目的:
- 为了确定是否需要肺静脉的完全电隔离,以成功地进行心房动的导管切除.
- 评估一种纯粹解剖学方法的疗效,用于在患有AF的患者中进行PV骨的射频切除.
主要方法:
- 五十一名患有阴道发作或持续性AF的患者使用解剖方法进行了PV骨的周边射频切除.
- 除终点被定义为病变内的低双极电位 (<0.1 mV).
- 左心房节奏评估了PV-左心房导电;随访时间平均为16.6个月.
主要成果:
- 80.4%的患者 (41/51) 在摘除后仍然没有心房律乱.
- 在AF复发和不复发的患者之间,没有观察到达到的废除终点或PV隔离率的显著差异.
- 完全的PV隔离很少被证明,即使在成功治疗的患者中也是如此.
结论:
- 导管切除的纯解剖方法可以在80%以上的患者中预防AF.
- 肺静脉的完全电隔离对于治愈AF并不是必不可少的.
- 该研究强调了针对PV骨的解剖学效果,而不是仅仅关注电气隔离.
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