Thibaut Moulin, Thomas D'Humieres, Gonzalo De Luna, Marine Thuillot, Thomas Chastre, Estelle Gandjbakhch, Eloi Marijon, Pablo Bartolucci, Nicolas Lellouche
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引用次数: 0
摘要
成人镰状细胞性贫血(SCA)患者是心房心律失常的高危人群;然而,关于心房颤动(AF)消融在这一人群中的结果的数据很少。方法和结果:回顾性纳入8例连续在3个三级消融中心行房颤消融的SCA患者(6例男性,平均年龄46±9岁)。患者表现出严重的左房重构(平均左房容积71±14 mL/m2), 6例出现持续性房颤。消融技术包括射频(RF, n = 6)、低温球囊(n = 1)和脉冲场消融(PFA, n = 1)。3例患者在肺静脉隔离之外接受了额外的LA病变。12个月时,7例患者(88%)无房性心律失常,88%停用抗心律失常治疗,NYHA评分由2.00±0.93分显著提高至1.38±0.52分(p = 0.049)。射频消融后无重大并发症报告。低温球囊病例并发急性胸综合征,PFA后出现中度溶血,无临床后果。结论:房颤导管消融治疗SCA患者有效。虽然射频消融显示出令人放心的安全性,但与低温球囊和PFA相关的特定风险需要进一步调查。
Multicenter Experience of Catheter Ablation for Atrial Fibrillation in Sickle Cell Anemia.
Introduction: Adult patients with sickle cell anemia (SCA) are at high risk for atrial arrhythmias; however, data on the outcomes of atrial fibrillation (AF) ablation in this population are scarce.
Methods and results: Eight consecutive SCA patients undergoing AF ablation in three tertiary ablation centers were retrospectively included (6 males, mean age 46 ± 9 years). Patients exhibited severe left atrial (LA) remodeling (mean indexed LA volume 71 ± 14 mL/m2) and six presented with persistent AF. Ablation techniques included radiofrequency (RF, n = 6), cryoballoon (n = 1), and pulsed-field ablation (PFA, n = 1). Three patients received additional LA lesions beyond pulmonary vein isolation. At 12 months, seven patients (88%) were free from any atrial arrhythmia, with 88% off antiarrhythmic therapy, and NYHA class significantly improved from 2.00 ± 0.93 to 1.38 ± 0.52 (p = 0.049). No major complications were reported following RF ablations. The cryoballoon case was complicated by an acute chest syndrome, while moderate hemolysis occurred following PFA, without clinical consequence.
Conclusion: AF catheter ablation appears effective in SCA patients. While RF ablation showed a reassuring safety profile, specific risks associated with cryoballoon and PFA warrant further investigation.
期刊介绍:
Journal of Cardiovascular Electrophysiology (JCE) keeps its readership well informed of the latest developments in the study and management of arrhythmic disorders. Edited by Bradley P. Knight, M.D., and a distinguished international editorial board, JCE is the leading journal devoted to the study of the electrophysiology of the heart.