脉冲场切除与冷热气球切除在患有持续心房的患者中
Corinne Isenegger1,2, Rebecca Arnet1,2, Fabian Jordan1,2
1Department of Cardiology, University Hospital Basel, Basel, Switzerland.
概括
脉冲场移除 (PFA) 提供较短的手术时间和类似的疗效,与冷热气球移除相比,持续性心房动 (AF) 患者. 此外,PFA的转化率也更高,从持久性AF转变为 Paroxysmal AF.
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:
- 持久性心房动 (AF) 对除疗法提出了挑战.
- 结冷气球 (Cryo) 除与高率的肺静脉 (PV) 再连接有关.
- 脉冲场切除 (PFA) 成为AF切除的潜在优越替代方案.
研究的目的:
- 为了比较PFA与Cryoablation的疗效和安全性.
- 评估PFA和冷在患者进行肺静脉隔离 (PVI) 持续AF.
主要方法:
- 一项对220名持久性AF患者进行PVI的比较研究.
- 患者接受了PFA (113) 或冷 (107) 的治疗.
- 评估的结果包括手术持续时间,无复发生存率和AF类型转换.
主要成果:
- PFA组的手术持续时间,LA停留时间和光镜时间显著缩短.
- 随访1年后的无复发生存率为PFA的72%,而冷的60% (p=0.079).
- 在PFA后,较高的比例的患者从持久性转化为性AF (68%) 与冷 (37%) 相比 (p=0.011).
结论:
- 在持久性AF患者中,PFA证明了更短的手术时间和与冷却切除相匹配的疗效.
- PFA与AF类型从持久性回归到 Paroxysmal回归的可能性更大.
- 需要进一步的研究来探索超越PVI的PFA策略.
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