在可行性上的差异,预测程序困难的解剖学参数,以及使用射频与冷热气球导管隔离左心房后壁隔离的隔离区域
Satoshi Sakai1, Akihiro Takitsume1, Tsunenari Soeda1
1Department of Cardiology, Nara Prefecture General Medical Center, Nara, Japan.
Pacing and clinical electrophysiology : PACE
|September 14, 2023
概括
射频除在持续性心房的患者中实现了左心房后壁隔离的更高成功率. 然而,冷气球除创造了更大的隔离区域,尽管完成率较低.
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:
- 持续性心房动 (PersAF) 管理通常需要辅助左心房后壁隔离 (LAPWI).
- 除能量的选择,射频除 (RFA) 与冷却气球除 (CBA),可能会影响LAPWI的结果.
- 了解这些差异对于优化PersAF治疗策略至关重要.
研究的目的:
- 为了比较RFA和CBA对LAPWI在PersAF患者中的疗效.
- 为了确定程序困难和不完整的LAPWI的解剖学预测因素.对于两个能源.
- 评估和比较RFA和CBA在LAPWI期间实现的隔离区域.
主要方法:
- 一项涉及95名患者 (RF组) 和93名患者 (CB组) 进行肺静脉隔离 (PVI) 以及LAPWI的比较研究.
- 术前计算机断层扫描 (CT) 用于对LAPWI难度的解剖学评估.
- 删除后的3D绘图来量化LAPWI的面积.
主要成果:
- 与CBA (72.0%) 相比,LAPWI完成率与RFA (88.4%) 显著更高.
- 不完整LAPWI的预测因子不同:LIPV-食道距离对于RFA,LAPW角度/直径对于CBA.
- 非肺静脉隔离区域在CBA (27.5厘米) 时比RFA (22.9厘米) 更大.
结论:
- 在PersAF中,RFA显示LAPWI的程序成功率更高.
- 影响LAPWI成功的解剖学因素取决于所使用的切除方式.
- 与RFA相比,CBA实现了更广泛的切除区域,但完成率较低.
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