在75岁以上的老年人中用于心房的脉冲场切除:系统性审查和元分析
Patavee Pajareya1, Khamik Laohasurayotin1, Witina Techasatian2
1Division of Cardiovascular Medicine, Center of Excellence in Arrhythmia Research, Cardiac Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
Pacing and clinical electrophysiology : PACE
|March 5, 2026
概括
脉冲场切除 (PFA) 在老年患者与年轻患者相比,在心房动 (AF) 中表现出类似的疗效. 然而,老年人在PFA程序中出现并发症的风险更高.
科学领域:
- 心血管医学 心血管医学
- 电力生理学 电力生理学
- 老年心脏病学 老年心脏病学
背景情况:
- 脉冲场切除 (PFA) 是一种针对心房动 (AF) 的创新性导管切除技术.
- 关于PFA的安全性和有效性的数据有限,特别是在老年人群 (≥75岁) 中.
- 本综述全面评估了老年患者的PFA利用情况.
研究的目的:
- 系统地审查和比较PFA在老年人中的安全性和有效性与非老年患者的AF.
- 分析经过PFA的不同年龄组的并发症率和心律失常复发率.
主要方法:
- 在PubMed上进行了系统的文献搜索,截至2025年7月.
- 包括比较PFA在老年 (≥75岁) 和非老年患者的安全性和有效性结果的研究.
- 安全结果包括整体,主要 (中风,吸管,等等). ) 和轻微的并发症. 疗效结局包括复发的时间和没有心律失常的存活率.
主要成果:
- 分析了10项涉及5948名患者的研究 (900名老年人,5048名非老年人).
- 与非老年患者相比,老年患者的整体 (OR 1.93),主要 (OR 1.93) 和轻微 (OR 2.08) 并发症风险明显更高.
- 无心律失常生存率在两组之间相似 (OR 0.81),在手术或光镜时间方面没有显著差异.
结论:
- 与非老年人相比,PFA在老年患者的AF治疗中表现出与非老年人相比的有效性.
- 然而,接受PFA的老年患者面临着更容易出现手术并发症的倾向.
- 在考虑老年人PFA时,仔细选择和监测患者至关重要.
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