左心房底物修饰和肺静脉隔离使用一种新型圆形可变回路脉冲场消融导管。

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
European Heart Journal: Case Reports Pub Date : 2025-05-06 eCollection Date: 2025-05-01 DOI:10.1093/ehjcr/ytaf209
Alessandro Parlato, Moneeb Khalaph, Philipp Sommer, Christian Sohns
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引用次数: 0

摘要

背景:脉冲场消融(PFA)是最近发展起来的一项技术,通过电穿孔引起组织坏死,已被用于肺静脉隔离(PVI)心房颤动(AF)消融。只有少数设备获得了CE标志,VaripulseTM导管(VaripulseTM, Biosense Webster, Irvine, USA)是一种可变环PFA导管,最近已获得批准。尽管PVI的经验越来越丰富,但关于使用PFA导管和线性消融病变的证据缺乏,PFA导管可能会减少手术相关的成本和时间。病例总结:一名患有多种心血管危险因素的73岁白人女性出现高度症状性阵发性房颤,并计划使用新型Varipulse导管进行PFA房颤消融。手术是在深度镇静下进行的,导管通过中隔穿刺推进。左心房三维电解剖图显示前壁明显纤维化。PVI后,通过前二尖瓣线(AML)入路进行底物修饰。AML在额外的PFA应用下进行,通过起搏操作确认双向阻滞成功,没有任何程序性并发症。患者于次日出院,无症状,健康状况良好。结论:在房颤患者中,使用新型Varipulse PFA导管,除了PVI外,还可以进行单独的LA底物修饰,包括线性病变集。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Left atrial substrate modification in addition to pulmonary vein isolation using a novel circular variable loop pulsed field ablation catheter.

Background: Pulsed field ablation (PFA) is a recently developed technology that causes tissue necrosis through electroporation and has been employed and validated for pulmonary vein isolation (PVI) in atrial fibrillation (AF) ablation. Only few devices have received a CE mark for this use and the VaripulseTM catheter (VaripulseTM, Biosense Webster, Irvine, USA), a variable loop PFA catheter, has been recently approved. Despite the growing experience with PVI, evidence is lacking about the use of PFA catheters and linear ablation lesions, which could potentially be performed with PFA catheters, reducing procedure related costs and time.

Case summary: A 73-year-old Caucasian woman with multiple cardiovascular risk factors presented with highly symptomatic paroxysmal AF and was scheduled to undergo PFA AF ablation using the new Varipulse catheter. The procedure was performed under deep sedation and the catheters were advanced through trans-septal puncture. 3D electroanatomic mapping of the left atrium showed significant anterior wall fibrosis. After PVI, substrate modification through an anterior mitral line (AML) approach was pursued. The AML was performed with additional PFA applications and successful bidirectional block was confirmed by pacing maneuvers without any procedural complications. The patient was discharged the following day, asymptomatic and in a state of well-being.

Conclusion: Individual LA substrate modification, including linear lesion sets, can be delivered in addition to PVI using the novel Varipulse PFA catheter in patients with AF.

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来源期刊
European Heart Journal: Case Reports
European Heart Journal: Case Reports Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.30
自引率
10.00%
发文量
451
审稿时长
14 weeks
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