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仅PVI对所有持久性AF患者来说是不够的:A FLOW-AF亚组分析分析

Atul Verma¹, Steven Castellano², Melissa H Kong²

¹McGill University Health Centre, Montréal, Québec, Canada.

|October 24, 2024

概括

只有肺静脉隔离 (PVI) 的切除在持久性心房动 (PeAF) 患者的电图流 (EGF) 识别源下不太成功. 为了获得更好的结果,EGF映射有助于识别可能需要除PVI外的额外切除的患者.

科学领域:

电子生理学电子生理学
通过心脏切除术 (Cardiac Ablation) 进行心脏切除.
心房动病理生理学

背景情况:

在STAR-AF II之后,对于持续性心房 (PeAF) 只有肺静脉隔离 (PVI) 策略的趋势存在.
电图流 (EGF) 映射识别了心房动 (AF) 的来源,并评估了波面传播一致性 (EGFC),揭示了功能性AF机制.

研究的目的:

为了评估PVI-only废除策略的有效性,在患者中进行重复废除,以治疗持久或长期持久的心房动.
确定电图流 (EGF) 识别的来源是否会影响PVI-only切除在这个患者群体中的成功.

主要方法:

在FLOW-AF试验中,前性地招募了经过重复切除的非气囊性AF患者.
在PVI之前和之后获得了电图流 (EGF) 记录.
患有EGF鉴定来源的患者被随机分配到EGF导向切除与仅PVI相比;没有来源的患者大多只接受PVI.

主要成果:

没有EGF识别来源的患者接受PVI-only切除后,1年后70%的患者没有复发性AF (FFAF) 率.
只有PVI随机选择的EGF鉴定源患者的FFAF率明显较低,为35% (P = .018).
较高的电图流一致性 (EGFC) 与较好的结果相关 (67% FFAF) 与较低的EGFC (45% FFAF,P = .011).

结论:

在没有EGF识别的来源的患者中,PVI-only除成功率高于那些随机选择PVI-only的患者.
在异质的PeAF群体中,EGF识别的来源的存在具有临床意义.
对于所有持久性心房动的患者来说,仅PVI消化可能不足.

关键词:

节律失常是一种失常.心房动是一种心房动.篮子导管导管篮子导管导管一个心脏病患者的心脏病.电子图形流量绘制地图全景地图绘制肺静脉切除术是一种肺静脉切除术.

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