技术,评价,和后果的线性阻断在左心房屋顶在心房发症:一个前性随机研究
Mélèze Hocini1, Pierre Jaïs, Prashanthan Sanders
1Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux 2, Bordeaux, France.
Circulation
|December 14, 2005
概括
这项研究表明,在心房动 (AF) 移除过程中,在上肺静脉 (PVs) 之间阻断屋顶线是可行的. 这种技术改善了与光伏隔离单独相比的结果.
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 医疗器械
背景情况:
- 没有先前的报告详细介绍了帕洛西斯马性心房动 (AF) 患者在连接上肺静脉 (PVs) 的屋顶线上完全线性阻塞的技术,电生理学评估或临床结果.
研究的目的:
- 评估在患有偏激性AF的患者中连接上方PV的屋顶线上的完整线性块的可行性和临床后果.
主要方法:
- 90名药物耐药性 Paroxysmal AF 患者被随机分配到 PV 隔离 (n=45) 或 PV 隔离加上屋顶线切除 (n=45).
- 屋顶线切除涉及在左前庭 (LA) 屋顶上创建一个线性块,通过在LA附属体加速度时展示完整的导电块来证实.
- 评估了电生理学参数,包括纤维化周期长度,心律失常终止和非诱导性.
主要成果:
- 在接受此程序的96%的患者中,在屋顶线上实现了完整的导电阻塞.
- 屋顶线切除显著增加了纤维化周期长度 (217+/-44毫秒),并导致47%的AF终止,59%的可诱导患者的非诱导性.
- 虽然LA飞在22%的患者中被诱导,但屋顶线组在15个月后表现出更高的无心律失常率 (87%vs69%仅用于PV隔离).
结论:
- 在LA屋顶的完整线性块是可行的,可以使用射频剥离来实现.
- 这种技术延长了纤维化周期,终止了AF,并且与单独的PV隔离相比,改善了临床结果.
- 屋顶线切除是一种有前途的策略,用于管理耐药性 Paroxysmal AF.
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