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在持续的心房动中进行切除:使用严格的方案进行脉冲场切除的长期成功率高

Ehud Chorin¹, Shir Frydman¹, Arie Lorin Schwartz¹

¹Tel Aviv Sourasky Medical Center and Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.

|August 27, 2025

概括

脉冲场切除 (PFA) 与后壁隔离 (PWI) 和肺静脉隔离 (PVI) 结合,有效治疗持续性心房动 (PersAF). 这种以心内回声学 (ICE) 为指导的方法在12个月后取得了72%的成功率.

科学领域:

电生理学
心血管医学
医疗技术

背景情况:

后壁隔离 (PWI) 经常被添加到肺静脉隔离 (PVI) 进行持续性心房动 (PersAF) 切除,以减少复发.
基于射频 (RF) 的PWI由于难以实现持久的病变而取得有限的成功.
脉冲场切除 (PFA) 为持久PWI提供了一个有前途的替代方案.

研究的目的:

用PFA评估PVI加PWI在PersAF患者中的疗效.
通过心内回声学 (ICE) 和高输出节拍来确认PVI和PWI的组织接触可视化的有效性.

主要方法:

这是一项针对使用FARAPULSE PFA系统进行首次切除的PersAF连续患者的前性研究.
一个严格的协议,包括连续的ICE用于组织接触可视化和高输出步调以确认PVI和PWI.
包括109名患有PersAF的患者,使用PFA进行PVI和PWI.

主要成果:

在所有109名患者中成功实现了PVI和PWI,没有并发症.
在12个月的随访中,72%的患者 (79/ 109) 没有复发性心房律乱.
在90%的静脉中证实了持久PWI,在87%的患者中证实了持久PWI.

结论:

在ICE和步调确认的指导下,PFA与PVI相结合,对PersAF的切除具有很高的长期疗效.
这一策略为患有持续性心房的患者提供了安全有效的治疗选择.

关键词:

前庭动结果持久的后壁隔离-心内回声学脉冲场移除

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