用高功率短时间无线电频率和脉冲场除来加热食道和损伤食道
Armen A Kocharian1, Adi Lador1, Sufen Wang1
1Division of Cardiac Electrophysiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.
高功率短时间射频切除 (HPSD-RFA) 和脉冲场切除 (PFA) 可以导致食道温度升高和急性损伤. 经过30天,PFA诱导的损伤无法检测,并且独立于热效应.
科学领域:
- 心血管干预 心血管干预
- 电子生理学 电子生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 高功率短时间 (HPSD) 射频切除 (RFA) 和脉冲场切除 (PFA) 的目的是尽量减少食道损伤.
- 这些技术所带来的食道加热和损伤的确切风险仍然不确定.
研究的目的:
- 评估与HPSD-RFA和PFA相关的光线食道温度 (LET) 变化和食道损伤风险.
- 在食道附近,比较不同除策略的安全性.
主要方法:
- 在体内猪模型中,使用HPSD-RFA (50W/10s或90W/4s) 或PFA (STSF双能量或Omnypulse导管) 进行了肺静脉切除.
- 猪的ex vivo食道被用来进行比较分析.
- 评估了光线食道温度 (LET),温度上升率 (dT/dt) 和组织学结局 (急性和1个月).
主要成果:
- 与90W/4s相比,50W/10s的HPSD-RFA在50W/10s导致更高的峰值LET和dT/dt,而50W/10s导致持续的粘膜病变.
- 使用STSF导管的PFA比使用Omnypulse导管显示出更高的峰值LET和dT/dt;PFA发生了急性外肌病变,但在30天内无法检测到.
- 活体研究表明,在RFA和PFA-STSF之间,LET的增加是可比的.
结论:
- 无论是HPSD-RFA还是PFA都可以诱导LET升高和急性食道损伤.
- 与PFA相关的食道损伤似乎独立于热效应,并在30天内消失.
- 研究结果表明,PFA与HPSD-RFA相比,在长期食道损伤方面可能提供更安全的替代方案.
更多相关视频
04:58Reduced Procedure Time and Variability with Active Esophageal Cooling During Radiofrequency Ablation for Atrial Fibrillation
Published on: August 25, 2022
05:43Author Spotlight: Improving Lesion Contiguity in Pulmonary Vein Isolation via Proactive Esophageal Cooling
Published on: April 19, 2024
相关概念视频
Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
Barrett Esophagus-I: Introduction
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
