血管内交感刺激以促进早发性心室综合体的导管切除
Timothy M Markman1, Cory M Tschabrunn1, David Callans1
1Section for Cardiac Electrophysiology, Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Philadelphia.
JAMA cardiology
|December 23, 2024
概括
通过脊髓静脉 (VVs) 直接刺激交感神经,可以在导管切除过程中安全地引起过早的腹腔复合体 (PVCs). 这种技术提高了对患有不常见PVC的患者的切除程序的有效性.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 在导管切除过程中罕见的早产腹腔复合体 (PVCs) 限制了手术的疗效.
- 通过脊髓静脉 (VVs) 对交感神经的血管内刺激可以激活心脏交感声调,并可能诱导PVCs.
研究的目的:
- 评估通过VVs直接电气交感神经刺激的能力,以在导管切除过程中诱导PVCs.
- 评估VV刺激对PVC诱导的安全性和有效性. 在患者中进行切除.
主要方法:
- 15名成年患者的前景病例系列,为PVC进行了导管切除,难以挑起.
- 进行左侧VV (20Hz,高达25mA) 的电刺激.
- 在VV刺激之前,期间和之后,使用多级混合效应的Poisson回归来评估PVC频率.
主要成果:
- 所有患者 (15/15) 在VV刺激期间都经历了PVC (平均8.2个PVC/分钟),而此前的PVC平均为1.3个PVC/分钟.
- 经过VV刺激后,经过切除后观察到平均1.3%的PVC负荷,其中9/15名患者实现了<1%的负荷.
- 与VV刺激有关的不良事件没有报告.
结论:
- 通过VVs进行血管内交感刺激是一种安全有效的方法,可以在导管切除过程中引起PVC.
- 这种技术可以帮助识别和切除患有挑战性PVC的患者的节律失常基质.
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