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对耐火性典型心房抗多次射频除的脉冲场除:技术报告
Shaojie Chen1,2, Anna Neumann3, Gozal Mirzayeva3
1Department of Internal Medicine B (Cardiology, Angiology, Pneumology and Internal Intensive Care Medicine), University Medicine Greifswald, Greifswald, Germany. drsjchen@126.com.
概括
脉冲场除 (PFA) 提供了一种新的解决方案,用于在射频 (RF) 除失败时反复出现的心房动. 这一案例研究表明PFA.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗技术 医疗技术 医学技术
背景情况:
- 经常出现的典型心房动往往需要重复切除手术.
- 射频 (RF) 除向洞穴脊峡 (CTI) 可能无法实现持久的阻塞,导致持续性心律失常.
- 患有多次先前的射频废除的患者,由于心房基板痕而存在挑战.
研究的目的:
- 为了评估脉冲场除 (PFA) 的疗效和安全性,在患有长期,复发性典型心房的患者中,对多次射频除具有耐火性.
- 在复杂的患者场景中证明PFA在实现持久的CTI阻断中的使用.
- 评估PFA对CTI依赖性心房的长期结果.
主要方法:
- 电生理学测绘以确定在病史上有四次先前的射频废除的患者中残留的CTI导电.
- 脉冲场切除 (PFA) 使用针对CTI的五线导管.
- 在PFA后重新绘制高密度电压,以确认持久的电阻.
- 临床随访1年,没有抗心律失常疗法.
主要成果:
- 通过PFA成功消除了CTI的残留碎片化心房电图.
- 持久的双向CTI区块通过删除后的重新映射来证实.
- 手术后没有诱导性心律失常,并在1年的随访期处于无心律失常状态.
- 这项手术没有并发症,没有神经受伤或其他不良影响.
结论:
- 脉冲场切除 (PFA) 是一种可行且安全的替代方案,用于治疗复发性CTI依赖心房的患者,这些患者多次常规RF切除都失败了.
- PFA可以在整个CTI实现持久的电阻,即使在复杂的,先前被废弃的基板中.
- 需要进一步的前性研究来证实这些发现,并确定这种患者群体中PFA的长期结果.
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