在持久性心房中,左心房后壁隔离与脉冲场切除
Melanie A Gunawardene1,2,3, Gerrit Frommeyer4, Christian Ellermann4
1Department of Cardiology and Intensive Care Medicine, Asklepios Hospital St. Georg, 20099 Hamburg, Germany.
Journal of clinical medicine
|October 14, 2023
概括
导向左心房后壁隔离 (LAPWI) 的脉冲场切除 (PFA) 是对持续性心房动 (persAF) 患者的肺静脉隔离 (PVI) 的安全有效补充. 这种方法显示出有利的结果,改善了导管切除手术中的节律控制.
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:
- 左心房后壁隔离 (LAPWI) 可能增强持续心房动 (persAF) 患者的节律控制,这些患者接受了导管切除 (CA),补充了肺静脉隔离 (PVI).
- 传统的热能来源对有效和安全地执行LAPWI提出了挑战.
研究的目的:
- 为了评估使用非热脉冲场除 (PFA) 对于LAPWI在CA期间在persAF患者的疗效和安全性.
- 为了比较PFA引导的LAPWI与PVI的结果,与单独PFA引导的PVI相比.
主要方法:
- 来自德国两个中心的连续persAF患者的未来招生.
- 研究了两个队列:一个是使用PFA引导的 (re) PVI和LAPWI,一个是仅使用PFA引导的PVI的比较队列.
- 患者使用常规的霍尔特心电图进行了随访.
主要成果:
- 总共包括79名persAF患者;59人接受了PFA指导的LAPWI (包括索引和重复程序),16人仅接受了PFA指导的PVI.
- 在LAPWI队列患者中,LAPWI在100%的患者中成功进行,并发症率低,没有检测到食道病变.
- 经过354天的平均随访后,LAPWI队列中心房失常率为79.3%,与PVI组相比,急性程序或临床结果没有显著差异.
结论:
- 以PFA为指导的LAPWI是一种可行且安全的辅助治疗,用于接受CA.CA的persAF患者.
- 该程序显示了有利的结果,表明它可以是一个有效的选择,当与持久PVI结合.
相关概念视频
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