冠状动脉鼻腔信号振幅:心房基板和低电压区域的预测指标
Yazan Mohsen1,2, Nora Großmann1, Jennifer Draheim1
1Department of Cardiology, Electrophysiology and Rhythmology, Krankenhaus Porz am Rhein, Cologne, Germany.
Pacing and clinical electrophysiology : PACE
|September 9, 2024
概括
冠状动脉鼻 (CS) 信号振幅可以预测左心房 (LA) 中的低电压区域 (LVAs),帮助心房动 (AF) 除成功. 这种非侵入性方法在无法进行高级映射的情况下提供了有价值的LA基质洞察力.
科学领域:
- 电力生理学 电力生理学
- 心脏节律失常症 心脏节律失常症
- 医学诊断 医学诊断 医学诊断
背景情况:
- 低电压区域 (LVAs) 在心房 (AF) 病变发生过程中至关重要,并影响切除成功.
- 肺静脉隔离 (PVI) 使用冷却气球 (CB) 切除是有效的,但不能识别LVAs.
- 评估LA基质对于优化AF切除策略至关重要.
研究的目的:
- 调查冠状动脉鼻 (CS) 信号幅度是否可以预测左心房 (LA) 电压和LVAs.
- 确定CS信号振幅的诊断实用性,用于在AF剥离过程中识别关键的LA基质.
主要方法:
- 对284名患有复发性AF的患者进行了回顾性分析,这些患者接受了射频导管切除.
- 在LA电压/LVAs和CS信号幅度之间的相关性分析.
- 评估CS信号切断值,以预测严重和最小的LVAs.
主要成果:
- CS信号幅度与LA电压有显著的相关性,特别是在近端CS (ρ=0.81,p<0.001).
- 一个1.155mV的CS切线预测了严重的LVAs (> 40%),具有90.7%的灵敏度和100%的特异性.
- 一个1.945mV的值确定了患有最小LVAs (<5%) 的患者,其灵敏度为88%和特异性为50% (AUC:0.81).
结论:
- CS信号振幅是LA电压和LVAs的可靠指标.
- CS信号振幅可以作为评估LA基板的有价值的诊断工具,特别是当3D映射无法使用时.
- 这一发现可能会提高AF切除手术的个性化和有效性.
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