节律失调的右室心肌病与广泛的异常基质:隔离是可能的吗?
Nan Wu1, Hongwu Chen2, Weizhu Ju2
1Gusu School, Nanjing Medical University, Suzhou, China.
JACC. Clinical electrophysiology
|June 3, 2023
概括
电隔离右心室自由壁 (RVFW) 是一种可行的策略,用于心律失常的右心室心肌病症 (ARVC) 患者,具有广泛的异常基质,有效控制心室心力衰竭 (VT). 这种方法为管理复杂的ARVC案件提供了一个可行的选择.
科学领域:
- 电力生理学 电力生理学
- 心脏病学 心脏病学
- 通过心脏切除术 (Cardiac Ablation) 进行心脏切除.
背景情况:
- 节律失调的右心室心肌病 (ARVC) 在管理广泛的右心室自由壁 (RVFW) 异常基质方面提出了挑战.
- 使用结合表心和内心方法的传统大面积均化需要大量的时间,并且往往不足以在ARVC中进行基质修饰.
研究的目的:
- 评估隔离异常RVFW基质的可行性和有效性在患有心室动脉冲动 (VT) 的ARVC患者中.
- 探索一种有针对性的方法来管理ARVC中复杂的RV基板.
主要方法:
- 八名ARVC患者有VT和广泛的RVFW异常基质,在鼻腔节律期间进行了详细的电压映射.
- 沿着RVFW的低压区域边界区域创建了环形线性损伤,用于电气隔离.
- 额外的带有分离或晚期潜力的区域被同质化;在切除前和后进行静脉引.
主要成果:
- 在62.5%的患者中,通过单独的内心方法实现了异常RVFW基质的电隔离,37.5%的患者通过结合的内心/表心方法实现了电隔离.
- 所有患者 (100%) 在消去后对静脉瘤无诱导性.
- 随访时间中位数为43个月,87.5%的患者没有持续性静脉瘤.
结论:
- 电气隔离RVFW是ARVC患者具有广泛的异常基质的可行和有效策略.
- 这种技术在复杂的ARVC病例中为控制VT提供了有价值的治疗选择.
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