慢性心房动的射频导管切除,由复杂的电图指导
Hakan Oral1, Aman Chugh, Eric Good
1Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, USA. oralh@umich.edu
Circulation
|May 16, 2007
概括
慢性心房动 (AF) 的射频移除显示了适度的短期成功,通常需要第二次手术超过40%的患者. 复发性心律失常与肺静脉活动和宏观输入电路有关.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械 医疗器械
背景情况:
- 通过复杂的分离性心房电图 (CFAE) 引导的射频导管切除已经显示出对心房动 (AF) 的承诺.
- 之前的研究包括有限数量的慢性AF患者.
研究的目的:
- 评估CFAE指导的射频导管切除在慢性AF患者中的疗效.
- 为了确定经过切除后复发性心房律乱的机制.
主要方法:
- 100名患有慢性AF的患者接受了射频除,针对CFAE在各种左心房区域和冠状动脉鼻.
- 废除成功被定义为终止AF或消除所有已识别的CFAE.
- 随访包括节律监测和评估对抗节律失常药物的需要.
主要成果:
- 经过一次性切除后,33%的患者在没有抗失常药物的情况下保持了鼻节律.
- 在44%的患者中,需要进行第二次切除手术.
- 在长期随访 (13+/-7个月后的最后一次切除),57%的患者在没有抗失常药物的情况下处于鼻节律.
结论:
- 由CFAE指导的射频除在慢性AF中提供了适度的短期疗效,经常需要第二次手术.
- 肺静脉的快速活动和多个宏导电路被确定为反复性心房律乱的常见机制.
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