脉冲场消去与热消去:随机对照试验的系统审查和元分析
Rahul Bussa1, Jatin Bussa2, Matthew Nudy3
1Penn State Hershey Medical Center, Heart and Vascular Institute, Division of Cardiology, Hershey, PA, USA.
Trends in cardiovascular medicine
|February 6, 2026
概括
脉冲场移除 (PFA) 与用于心房的热移除 (射频或冷热气球) 相比,并没有显著改善心房失常的自由度. 在PFA和热废除技术之间,不良事件发生率相似.
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:
- 导管切除是心房动 (AF) 的首要治疗方法.
- 射频除 (RFA) 和冷却气球除 (CBA) 是已知的热技术.
- 一种非热方法脉冲场切除 (PFA) 正在出现,但其与热方法相比的有效性尚不清楚.
研究的目的:
- 为了比较PFA与热除 (RFA/CBA) 的疗效,在AF患者中实现心房律乱自由.
- 通过评估严重的不良事件,评估PFA与热消化相比的安全性.
主要方法:
- 随机对照试验的元分析,比较PFA与热废除技术.
- 主要结局:12个月前心房节律失常自由.
- 二次结果:由严重的不良事件组成.
- 统计分析包括计算累积赔率比率 (OR) 和95%置信区间 (CI).
主要成果:
- 分析了三项试验,共有1237名参与者 (622名PFA,615名热).
- 与热性除相比,PFA在心房失常自由度没有显著差异 (OR 1.19;95% CI 0.85至1.65;p=0.31).
- 严重的不良事件在PFA和热废除组之间也是相似的 (OR 1.25;95% CI 0.48至3.26;p=0.64).
结论:
- 目前的证据表明,PFA在改善AF患者心房律乱自由度方面,与热废除技术相比,没有显著的优势.
- 严重不良事件所表明的安全性概况似乎可与PFA和热除相比较.
- 无论如何检测心律失常的方法或AF类型 (偏发性与持续性),都没有观察到任何显著差异.
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