室腔内心肌导航用于以电图为指导的心动脉移 (VINTAGE):深度移在不可访问的目标中
Rim N Halaby1, Christopher G Bruce2, Aravindan Kolandaivelu3
1Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
JACC. Clinical electrophysiology
|May 29, 2024
概括
由电图指导的心动脉内导航 (VINTAGE) 提供了一种新的解决方案,用于访问深层心脏目标. 这种安全有效的方法可以创建可重现的内壁病变,改善对挑战性心室动脉冲动的切除结果.
科学领域:
- 心血管研究研究心血管研究
- 电子生理学 电子生理学
- 最少侵入性手术的方法
背景情况:
- 深层室内静脉心动减速基底很难从传统的内心和心表表面进行切除.
- 高复发率与这些难以访问的目标的当前消去技术有关.
研究的目的:
- 引入和评估一种新的方法,即用电图 (VINTAGE) 引导的腹腔内心导航进行心动脉缩.
- 评估VINTAGE在进入和切除心肌内宫内心室内心力衰竭基质中的可行性,安全性和有效性.
主要方法:
- 在猪模型中,导线/微导管组合通过右心室腔深入血管外心肌.
- 通过光学,电图和电解剖学绘图来访问心脏内部的目标.
- 通过心脏内溶液灌进行射频除,并通过心脏MRI和尸体解剖分析病变.
主要成果:
- 在所有猪中成功实施了VINTAGE,产生了43个内病变.
- 95%的病变被MRI检测出来,88%通过尸体解剖检测出来,更大的病变是使用更大的导线和20W的废弃能量来实现的.
- 在20W的内肌心灌和切除导致阻抗大幅下降,并没有与并发症相关.
结论:
- VINTAGE是一种安全有效的技术,用于在传统上无法进入的腹腔心动节拍基质中创建室内移除病变.
- 采用心肌内导线灌和20W切除的VINTAGE方法,可以在心肌内产生可重复的大小病变.
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