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穿皮式机械支在心室心律失常的导管切除中:作还是希望?

Josef Kautzner^1,2, Jana Hašková^1,2, Predrag Stojadinovič¹

¹Department of Cardiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, Prague 140 21, Czech Republic.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

|July 19, 2024

概括

穿皮机械循环支持 (PMCS) 装置可能无法改善心室动脉冲动移除的结果,并可能增加并发症. 对于高风险患者来说,替代策略如无麻醉或心室辅助装置的基质修饰可能更安全.

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:

导管切除 (CA) 是结构性心脏病中复发性腹腔动脉动脉动 (VTs) 的标准.
穿皮机械循环支持 (PMCS) 装置在CA期间越来越多地在手术内使用.
对于PMCS的适应症包括救援疗法,高风险患者的预防性支持,以及非缺血性心肌病的基质鉴定.

研究的目的:

审查在不同的临床场景中使用各种PMCS设备进行静脉瘤切除.
评估PMCS对急性和长期结果以及并发症率的影响.
为接受静脉切除术的高风险患者讨论替代策略.

主要方法:

审查现有的文献和临床经验与PMCS在静脉瘤切除.
分析PMCS和没有PMCS治疗的患者的结果和并发症.
讨论替代管理策略,包括基质修饰,心室辅助装置和放射治疗.

主要成果:

在VT期间,PMCS允许绘制地图,但不会显著改善急性或长期结果.
在使用PMCS的队列中,并发症率似乎更高.
在没有全身麻醉的情况下进行基质修改,在严重左心室功能障碍的患者中是可行的.
在电风暴的末期心力衰竭中,可以优先使用心室辅助设备而不是CA.

结论:

在静脉切除过程中使用PMCS存在限制和潜在风险.
对于特定的高风险患者群体,替代策略可能更有利.
需要进行前性试验来评估这些方法.

关键词:

导管切除导管切除导管切除导管切除穿皮式机械支器穿皮式机械支器立体性心律失常放射治疗放射治疗基质的修改是基质的修改.腹腔动脉短心症是因为心室短心.

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