双极性切除涉及冠状动脉系统,用于耐火性左心室顶部心律不整
Andres Enriquez1,2, Matthew Hanson2, Babak Nazer3
1Section of Cardiac Electrophysiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Heart rhythm O2
|February 5, 2024
概括
针对左心室顶部 (LVS) 的双极切除疗法有效治疗耐火性早发性心室综合体 (PVCs) 和心室低心率 (VT). 这种使用冠状动脉和内心结构的先进技术显示出高的成功率和安全性.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 对于左心室顶部 (LVS) 过早心室综合体 (PVC) 和心室动脉障碍 (VT) 的导管切除通常需要先进的技术.
- 使用冠状动脉和相邻内心结构的双极性除为耐火性LVS心律失常提供了潜在的解决方案.
研究的目的:
- 评估冠状动脉系统与相邻内心内心左心室外流通道 (LVOT) 或右心室外流通道 (RVOT) 之间的双极切除术的疗效和安全性.
主要方法:
- 一项多中心研究包括20名患有LVS PVC/VT,耐单极切除的患者.
- 双极切除术是在前腔室间静脉 (AIV) 或大心静脉 (GCV) 和内心LVOT/RVOT之间进行的.
- 功率进行了定位,血管图证实了与冠状动脉的安全距离 (>5毫米).
主要成果:
- 在所有患者中都实现了PVC/VT的急性消除.
- 没有出现任何程序性并发症.
- 在30个月的随访中,观察到85%的非心律不整复发,PVC负担显著减少 (22%至4%).
结论:
- 冠状动脉系统和相邻内心LVOT/RVOT之间的双极性切除是一种安全有效的策略,用于对单极性切除无反应的LVS PVC/VT.
- 谨慎的功率定位和手术内血管造影对于确保与冠状动脉相对的安全至关重要.
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