Avitall Boaz, Kalinski Arthur
University of Illinois at Chicago, Chicago, Illinois.
University of Illinois at Chicago, Chicago, Illinois.
Heart Rhythm. 2015 Oct;12(10):2195-203. doi: 10.1016/j.hrthm.2015.05.034. Epub 2015 May 29.
This review focuses on the basic science of cellular destruction by tissue freezing and application of transvenous cryocatheter technology to treat cardiac arrhythmia. Ideally, foci for arrhythmias are selectively ablated, arrhythmogenic tissues are destroyed, and reentry circuits are bisected in order to silence adverse electrical activity, with the goal of restoring normal sinus rhythm. The mechanism of ablation using cryotherapy results in distinct lesion qualities advantageous to radiofrequency (Khairy P, Chauvet M, Lehman J, et al. Lower incidence of thrombus formation with cryoenergy versus radiofrequency catheter ablation. Circulation 2003;107:2045-2050). This review is devoted to the mechanism of cryoablation, postablation histopathological changes, and how this information should be used by the clinicians to improve safety and maximize ablation success.
本综述聚焦于组织冷冻导致细胞破坏的基础科学以及经静脉冷冻导管技术在治疗心律失常中的应用。理想情况下，心律失常病灶被选择性消融，致心律失常组织被破坏，折返环路被切断，以消除不良电活动，目标是恢复正常窦性心律。冷冻疗法的消融机制产生了对射频消融有利的独特病灶特性（Khairy P, Chauvet M, Lehman J等。冷冻能量与射频导管消融相比血栓形成发生率更低。《循环》2003年；107:2045 - 2050）。本综述致力于冷冻消融的机制、消融后的组织病理学变化，以及临床医生应如何利用这些信息来提高安全性并使消融成功率最大化。
