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在半正常的盐水灌射频废除过程中,心内回声可以减少蒸汽爆发吗?

Kanae Hasegawa^1,2, Zachary T Yoneda¹, Jose R Martines-Parachini¹

¹Cardiovascular Division, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (K.H., Z.T.Y., J.R.M.-P., E.M.P., G.E.D., T.Y.H., K.T., M.K., T.D.R., J.A.M., S.S., J.C.E., P.J.S., A.E., M.L.W., H.T., G.F.M., A.N.K., W.G.S.).

Circulation. Arrhythmia and electrophysiology

|May 28, 2024

概括

在灌无线电频率剥离过程中蒸汽爆发是未被认可的. 心内回声学 (ICE) 可以识别这些事件,往往由组织白化或增加的泡,允许更安全的切除手术.

科学领域:

电子生理学电子生理学
通过心脏切除术 (ablation) 进行心脏切除.
医疗成像医学成像

背景情况:

用半正常盐水进行灌射频切除可能会增加病变大小,但会带来蒸汽爆发等风险,可能导致栓塞或穿孔.
这项研究调查了心内心声谱 (ICE) 发现和阻抗变化作为在切除过程中蒸汽爆发的预测因素.

研究的目的:

为了确定心内心电回声学 (ICE) 发现和显著阻抗下降是否在灌射频废除过程中先发生蒸汽爆发.
为了评估蒸汽爆发的发生率和预测因素,在接受心室失常性心律移除的患者中.

主要方法:

100名接受内心心室内心律不整的患者用半正常的盐水进行放射频移除,并使用ICE监测.
根据在ICE上可视化的15-20欧姆阻抗下降,组织白化和泡形成,调整了射频功率.
蒸汽爆发被定义为在ICE上观察到的可听的事件或微泡的突然爆炸.

主要成果:

蒸汽爆发发生在2.0%的剥离应用中. 有弹出点的网站显示阻抗降低显著较大 (18%对13%).
切除部位的ICE可视化与较少的爆发 (1.4%与2.8%) 有关.
组织白化和ICE上增加的泡形成在89%的爆发之前,是蒸汽爆发的独立预测因素.

结论:

蒸汽爆发发生在2%的半正常盐酸射频应用中,并且可能在没有ICE的情况下未被识别.
ICE可以可视化蒸汽爆发的前体,例如组织变白或增加泡,从而使调整减少它们的发生.
没有观察到与蒸汽爆发相关的栓塞事件或心周溢出.

关键词:

心律失常,心脏节律失常,心脏病.超声心电图 (Echocardiography) 是一种心声回声仪.无线电频率剥离方式盐水溶液的使用方法这是蒸汽蒸汽.

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