不同射频导管消融治疗心房扑动的比较特点

IF 0.1 Q4 MEDICINE, GENERAL & INTERNAL
A. V. Yakushev, O. Paratsii
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引用次数: 0

摘要

导管消融在心房宏观再入性心律失常的治疗中居于首位。消融的主要可控参数是能量、暴露时间和导管尖端冷却的使用。传统的消融技术,由于电极不稳定,存在组织损伤不足的高风险。针对稳定性问题,提出了一种新技术——增加能量,减少应用时间。这项工作的目的是比较射频导管消融(RFA)使用8mm非冷却电极与4mm冷却电极和4mm冷却电极增加能量的结果。材料和方法。这项工作是基于对心房扑动患者导管消融结果的回顾性分析。根据使用射频能量参数和消融电极类型将患者分为3组。结果发现,能量增加组从RFA开始到达到成功标准的时间最短,辐射暴露最低。与两组采用传统方法的患者比较,差异有统计学意义。这种差异与由于使用高能量而减少应用本身的时间以及由于电极从目标区域位移的可能性较低而需要应用较少数量的应用有关。与传统技术相比,使用高能方案可以更快地达到成功标准(分别提高30%和22%),同时减少辐射暴露(分别提高27%和24%)。使用高能方案不会导致并发症的频率增加,可以认为是安全的临床使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative characteristics of different methods of radiofrequency catheter ablation in atrial flutter
Catheter ablation occupies the first place in the treatment of atrial macro reentry arrhythmias. The main controllable parameters in ablations are energy, duration of exposure and use of catheter tip cooling. With traditional ablation techniques, there is a high risk of insufficient tissue damage due to electrode instability. Regarding the issue of stability, a new technique was proposed – reducing the application time with increasing the energy. The aim of this work was to compare the results of radiofrequency catheter ablation (RFA) using an 8 mm uncooled electrode to a 4 mm cooled electrode and a 4 mm cooled electrode with increased energy. Materials and methods. The work is based on a retrospective analysis of the results of catheter ablations in patients with atrial flutter. Patients were divided into 3 groups depending on the parameters of the used radio frequency energy and the type of ablation electrode. Results. It was found that in the group with increased energy, there were the shortest time from the start of RFA to the achievement of success criteria and the lowest radiation exposure. The obtained differences were statistically significant in comparison with two groups of patients who underwent traditional methods. Such differences were associated both with a reduction in the time of the application itself due to the use of high energy as well as the need to apply a smaller number of applications owing to a lower probability of the electrode displacement from the target area. Conclusions. The use of a high-energy protocol allows to success criteria for cavo-tricuspid isthmus ablation more quickly compared to traditional techniques (by 30 % and 22 %, respectively) with less radiation exposure (by 27 % and 24 %, respectively). The use of the high-energy protocol does not lead to an increase in the frequency of complications and can be considered safe for clinical use.
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来源期刊
Zaporozhye Medical Journal
Zaporozhye Medical Journal MEDICINE, GENERAL & INTERNAL-
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审稿时长
8 weeks
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