结合脉冲场切除和左心房附属体封闭:一个多中心的比较研究
Mark T K Tam1, Pipin Kojodjojo2, Yat-Yin Lam3
1The Chinese University of Hong Kong, Hong Kong; Prince of Wales Hospital, Hong Kong.
Heart rhythm
|March 23, 2025
概括
结合脉冲场切除 (PFA) 与左心房附属物阻塞 (LAAO) 是可行的,但会增加显著的周周器件泄漏的风险. 需要进一步的研究来优化这种结合方法用于心房的治疗.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 心房的治疗往往涉及到左心房尾闭塞 (LAAO) 和肺静脉隔离 (PVI) 通过脉冲场切除 (PFA).
- 将PFA和LAAO结合在一个单一的手术中是一种有前途的策略,可以改善患者的治疗结果.
研究的目的:
- 为了比较PFA和LAAO联合程序的疗效和安全性,与独立的PFA或LAAO程序相比.
- 评估结果,如肺静脉隔离,LAAO成功,以及周围器件泄漏 (PDL).
主要方法:
- 一项回顾性队列研究,涉及36名接受PFA和LAAO联合治疗的患者,与独立LAAO (48名患者) 和独立PFA (52名患者) 组进行比较.
- PFA使用了Farapulse系统,随后是WATCHMAN FLX LAAO植入,在切除前后测量了肺脊厚度.
- 闭塞成功和显著的PDL (>3毫米) 在3个月后使用TEE或CT进行评估.
主要成果:
- 所有组合和PFA组都实现了急性PVI;成功的LAAO植入高 (97.2%组合,100%独立).
- 在组合组中,在PFA后立即观察到肺脊厚度的显著平均增加69.4%.
- 虽然整体PDL率相似,但相比单独的LAAO组 (2.2%,P=.013),组合组 (20%) 中的显著PDL发生频率更高.
结论:
- 结合PFA和LAAO是一种可行的方法,用于心房的管理.
- 该程序导致肺脊厚度在消去后显著增加.
- 在接受联合手术的患者中,显著的周周器件泄漏的患病率更高,需要进一步调查.
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