针对不响应肺静脉隔离的持续性AF进行ECGI向性切除:两阶段策略的结果 (TARGET AF2)
Gurpreet Dhillon1, Shohreh Honarbakhsh1, Hakam Abbas1
1Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
Heart rhythm O2
|November 8, 2023
概括
在初始肺静脉隔离 (PVI) 后,患有复发性持续性心房 (AF) 的患者中,电心图像学 (ECGI) 引导的潜在驱动器切除显示出良好的反应. 这种方法在一年后导致显著的心律失常,这表明它在管理持久性AF复发方面的有效性.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗成像医学成像
背景情况:
- 维持持续性心房动 (AF) 的机制尚未完全理解.
- 在肺静脉隔离 (PVI) 后复发的AF是一个临床挑战.
研究的目的:
- 评估在PVI后复发性持续性AF患者中潜在驱动因素的临床结果和废除反应.
- 评估ECGI表型的有效性,以指导废除策略.
主要方法:
- 100名患有持续性AF的患者接受了冷却气球PVI.
- 经常出现的病例经历了ECGI指导的已识别的潜在驱动因素 (PDs) 的切除.
- 主要结局是1年后不患心房律乱,不服用抗心律乱药物.
主要成果:
- 在26名复发性AF患者中,54%的患者在经过ECGI指导切除1年后没有心律失常.
- 总的来说,在最初的96名患者队列中,75%的患者在1年内实现了无心律失常.
- 在20名患者中观察到急性除反应,其中14名患者显示周期长度延长.
结论:
- 潜在驱动因子的ECGI导向除在PVI后复发性AF患者中有效.
- 这一策略为持续的AF管理带来了合理的长期成果.
- 进一步的研究可以优化废除目标,以改善患者的结果.
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