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马歇尔乙醇废除静脉作为复发性持续性心房的策略
Brian C Hsia1, Peter Zhang2, Joey Junarta1
1Leon H. Charney Division of Cardiology, New York University Langone Health, New York City, New York, USA.
Journal of cardiovascular electrophysiology
|September 29, 2025
概括
马歇尔静脉 (VOM) 乙醇切除并没有减少先前切除的患者心房动 (AF) 的复发. 这一策略也增加了左心房附属体 (LAA) 隔离的风险.
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 医疗器械
背景情况:
- 马歇尔静脉 (VOM) 乙醇切除对于持续性心房 (AF) 作为初始治疗有效.
- 有限的数据存在于其在以前的切除后复发的AF的疗效.
研究的目的:
- 调查VOM乙醇废除在患者经历复发的AF尽管之前的废除手术的有效性.
- 为了比较VOM乙醇切除结合 mitra isthmus切除与传统的重复切除策略.
主要方法:
- 对107名患有持续性AF的患者进行了回顾性分析,这些患者经历了重复的切除.
- 患者之前曾经经历过肺静脉隔离 (PVI),后壁隔离 (PWI) 和洞穴皮峡 (CTI) 切除.
- 病例接受了VOM乙醇切除和 mitralizmus切除;对照组接受了基质修饰和触发式切除.
主要成果:
- 在VOM (47%) 和对照 (38%) 组 (p=0.39) 之间1年AF复发没有显著差异.
- VOM组显示AF负担降低 (38%至10%,p=0.003) 和AF持久比例 (65%至26%,p=0.004).
- 与对照组相比,AF负担或复发减少没有显著差异;6%的VOM患者有LAA隔离.
结论:
- 在以前有PVI,PWI和CTI切除的患者中,VOM乙醇切除并没有减少AF复发或负担.
- 这种手术增加了手术内左心房附属体 (LAA) 隔离的风险.
- 对于复发性AF,使用基质修饰的常规重复切除可能比VOM乙醇切除更好.
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