用过导管进行脉冲场切除 左心室附属体的阻塞 左心室附属体的阻塞 - - 原始心室高心率
Junya Komatsu1, Hiroki Sugane1, Yuki Nishimura1
1Department of Cardiology, Chikamori Hospital, Kochi, Japan.
JACC. Case reports
|February 6, 2026
概括
脉冲场切除 (PFA) 结合左心房附属物阻塞 (LAAO) 是心房动脉冲动的一个可行的治疗方法. 在PFA之前仔细选择设备至关重要,以确保持久的密封,因为PFA可以导致LAA胀.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 脉冲场移除 (PFA) 是一种新兴的治疗方法,用于左心房附属体 (LAA) 起源的心房高心率 (AT).
- 在LAA中,PFA可能会增加血栓形成的风险.
- 同时的跨导管LAA封闭 (LAAO) 可以减轻这种风险.
研究的目的:
- 评估将PFA与LAAO结合用于LAA原产地AT的可行性和结果.
- 强调在PFA引起的LAA变化的背景下,设备选择的重要性.
主要方法:
- 一个54岁的男性病例研究,患有症状的LAA起源AT接受PFA.
- 使用透食管心声学进行的切除后评估揭示了LAA胀和孔径收窄.
- 植入一个Watchman FLX Pro设备,故意过度压缩以确保密封.
- 一个月的随访心脏CT以确认LAA密封和设备压缩.
主要成果:
- 一次成功的同时进行PFA和LAAO手术.
- 在PFA后观察到显著的乳酸盐肌肉胀和LAA孔狭窄.
- 在1个月的随访后,获得了完整的LAA密封,具有足够的设备压缩.
结论:
- 结合PFA和LAAO是一种可行的策略,用于管理LAA起源的AT.
- PFA可以诱导显著的LAA胀,需要仔细的手术前成像来选择合适的设备.
- 当与PFA同时使用时,准确的PFA前设备大小对于实现持久的LAA封闭至关重要.
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