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使用冷冻热能进行肺静脉电隔离:研究设计与初步结果。

Electrical isolation of pulmonary veins using cryothermal energy: study design and initial results.

作者信息

Scholten M F, Kimman G J, Janse P A, Thornton A S, Theuns D A M J, Jordaens L J

出版信息

Neth Heart J. 2003 Nov;11(11):453-458.

PMID:25696159
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2499941/
Abstract

UNLABELLED

In the September 2003 issue of the Netherlands Heart Journal, the wrong figures where inserted in this article. The article is reprinted here with the correct figures.

BACKGROUND

Atrial fibrillation (AF) is the most frequently encountered arrhythmia. Radiofrequency pulmonary vein (PV) ablation is promising for symptomatic paroxysmal AF, but is associated with a significant risk of PV stenosis.

OBJECTIVES

To assess the efficacy of cryothermal PV ablation and the incidence of PV stenosis.

METHODS

Highly symptomatic patients with paroxysmal or persistent AF were eligible for cryothermal ablation. Multislice spiral CT scans were performed before, and three months after ablation. AF burden was assessed using transtelephonic ECG recording and by telephone enquiry.

RESULTS

An attempt was made to isolate 27 PVs in 15 patients. In total, 20 PVs could be isolated (74% acute success). No significant difference in PV diameter was seen before and after ablation. Five out of 12 patients with paroxysmal AF were completely without AF after one ablation procedure. An additional two patients reported a significant reduction in symptoms. In the three patients with persistent AF no improvement was reported.

CONCLUSION

Cryothermal PV ablation was effective in isolation of the targeted PVs. It appears to be safe, as no PV stenosis was seen in this study three months after the ablation. Taking into account a learning curve, we consider the clinical results to be very promising.

摘要

未标注

在《荷兰心脏杂志》2003年9月期的这篇文章中插入了错误的数据。现重新刊登此文并附上正确数据。

背景

心房颤动(AF)是最常见的心律失常。射频肺静脉(PV)消融术对于有症状的阵发性AF有前景,但与PV狭窄的显著风险相关。

目的

评估冷冻球囊肺静脉消融术的疗效及PV狭窄的发生率。

方法

有高度症状的阵发性或持续性AF患者 eligible for冷冻球囊消融术。在消融术前及术后三个月进行多层螺旋CT扫描。使用电话传输心电图记录及电话询问评估房颤负荷。

结果

尝试对15例患者的27条肺静脉进行隔离。总共20条肺静脉可被隔离(急性成功率74%)。消融前后肺静脉直径未见显著差异。12例阵发性AF患者中有5例在一次消融术后完全无房颤发作。另外2例患者报告症状显著减轻。3例持续性AF患者未见改善。

结论

冷冻球囊肺静脉消融术在隔离目标肺静脉方面有效。本研究在消融术后三个月未见肺静脉狭窄,似乎是安全的。考虑到学习曲线,我们认为临床结果非常有前景。 (注:原文中“eligible for”未准确翻译出来,根据语境此处意思是“适合进行” )

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179a/2499941/30dbc112bec8/Nheartj00122-0020-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179a/2499941/62915dcd0bfc/Nheartj00122-0020-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179a/2499941/30dbc112bec8/Nheartj00122-0020-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179a/2499941/62915dcd0bfc/Nheartj00122-0020-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179a/2499941/30dbc112bec8/Nheartj00122-0020-b.jpg

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J Cardiovasc Electrophysiol. 2003 Apr;14(4):366-70. doi: 10.1046/j.1540-8167.2003.02334.x.
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Feasibility of pulmonary vein ostia radiofrequency ablation in patients with atrial fibrillation: a multicenter study (CACAF pilot study).
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Acute results of transvenous cryoablation of supraventricular tachycardia (atrial fibrillation, atrial flutter, Wolff-Parkinson-White syndrome, atrioventricular nodal reentry tachycardia).经静脉冷冻消融治疗室上性心动过速(心房颤动、心房扑动、预激综合征、房室结折返性心动过速)的急性结果
J Cardiovasc Electrophysiol. 2002 Nov;13(11):1082-9. doi: 10.1046/j.1540-8167.2002.01082.x.
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Irrigated-tip catheter ablation of pulmonary veins for treatment of atrial fibrillation.用于治疗心房颤动的肺静脉灌注射频消融导管
J Cardiovasc Electrophysiol. 2002 Nov;13(11):1067-73. doi: 10.1046/j.1540-8167.2002.01067.x.
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