对于持久性或长期持久性心房动而进行双重心上和心内过程 (DEEP)
Kenneth A Ellenbogen1, Ali Khoynezhad2, Mark La Meir3
1Divisions of Cardiology/Electrophysiology and Cardiac Surgery, Virginia Commonwealth University School of Medicine, Richmond (K.A.E., J.N.K., V.K.).
Circulation. Arrhythmia and electrophysiology
|September 30, 2025
概括
一种新的双上心脏和内心脏手术 (DEEP) 为持久性心房动 (PersAF) 和长期持久性心房动 (LSPersAF) 提供了安全有效的治疗方法,改善了不响应患者的废除结果.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 最少侵入性手术的方法
背景情况:
- 持续性心房动 (PersAF) 和长期持续性心房动 (LSPersAF) 仍然难以通过内心导管切除 (ECA) 治疗,导致治疗不足和不理想的结果.
- 患有非响应性或晚期AF的患者需要比传统ECA更好的治疗选择.
研究的目的:
- 评估PersAF/LSPersAF患者的左心房附属部分排除的结合表心和内心脏切除策略的安全性和有效性.
- 在一个前性的多中心试验中,评估双心和内心手术 (DEEP) 的结果.
主要方法:
- 在DEEP试验中,进行了两阶段的混合切除:最初的表心手术包括左心房附属体排除,然后在91121天后进行内心导管切除 (ECA).
- 对患者进行了12个月的随访,有效性定义为没有心房动脉节律失常,安全性由设备/程序相关的严重不良事件在指定的时间范围内评估.
主要成果:
- 该研究招募了90名患者 (平均年龄为63.4岁),其中83.3%的人患有PersAF,47.8%的人患有ECA.
- 主要安全终点显示,复合严重不良事件率为6.7%,达到安全目标.
- 12个月的初级疗效为71.8%,在2年后62.4%的患者没有心房动脉节律失常.
结论:
- 结合表皮心脏和内心脏技术的协作混合切除方法是管理PersAF和LSPersAF的安全和有效策略.
- 对于那些对先前的废弃试验反应不佳的患者来说,DEEP程序显示出有前途的结果.
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