在使用射频和脉冲场能量进行导管切除期间的心肌损伤,炎症,凝血和血小板活动
Pavel Osmancik1, Barbora Bacova2, Marek Hozman1
1Department of Cardiology, University Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic.
JACC. Clinical electrophysiology
|December 12, 2023
概括
与射频 (RF) 切除相比,对心房 (AF) 的脉冲场切除 (PFA) 显示了更高的心肌损伤,但类似的炎症和凝血激活. 此外,PFA程序也显著更快.
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:
- 脉冲场移除 (PFA) 是一种用于移除心房动 (AF) 的新型非热能源.
- 热除方法可以触发炎症和凝血反应.
研究的目的:
- 为了比较PFA和射频 (RF) 切除用于肺静脉隔离 (PVI) 之间的全身炎症,凝血和血小板激活反应.
主要方法:
- 一项随机试验比较了AF患者PFA和RF能量的PVI.
- 心肌损伤,炎症,凝血和血小板激活的全身标志物在手术前和后被测量.
- 关键标记物包括热素I,白内素-6,D-二次体和P-选择素.
主要成果:
- PFA程序比RF程序 (55分钟相比151分钟) 短得多.
- 在PFA组中,峰值热激素释放量明显高于PFA组 (10,102比1,006 ng/L).
- 无论是PFA还是RF剥离都诱导了类似的血小板和凝血激活水平 (>50%).
结论:
- 尽管心肌损伤增加,但PFA表现出可比的血小板/凝血激活和略低的炎症反应,而不是RF剥离.
- 与射频切除相比,PFA为PVI提供了更快的程序时间.
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