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用于肺静脉隔离的双相非对称脉冲场消融导管的初步临床评估。

A pilot clinical assessment of biphasic asymmetric pulsed field ablation catheter for pulmonary vein isolation.

作者信息

Chen Bingwei, Lv Chang, Cui Yingjian, Lu Chengzhi, Cai Heng, Xue Zhixiao, Xu Xinyu, Su Siying

机构信息

School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin, China.

Department of Cardiology, Tianjin First Central Hospital, Tianjin, China.

出版信息

Front Cardiovasc Med. 2024 Feb 7;11:1266195. doi: 10.3389/fcvm.2024.1266195. eCollection 2024.

Abstract

UNLABELLED

Pulsed field ablation (PFA) is a new treatment for atrial fibrillation (AF), and its selective ablation characteristics give it a significant advantage in treatment. In previous cellular and animal experiments, we have demonstrated that biphasic asymmetric pulses can be used to ablate myocardial tissue. However, small-scale clinical trials are needed to test whether this approach is safe and feasible before extensive clinical trials can be performed. Therefore, the purpose of this experiment is to determine the safety and feasibility of biphasic asymmetric pulses in patients with AF and is to lay the foundation for a larger clinical trial. Ablation was performed in 10 patients with AF using biphasic asymmetric pulses. Voltage mapping was performed before and after PFA operation to help us detect the change in the electrical voltage of the pulmonary veins (PV). 3-Dimensional mapping system showed continuous low potential in the ablation site, and pulmonary vein isolation (PVI) was achieved in all four PV of the patients. There were no recurrences, PV stenosis, or other serious adverse events during the 12 months follow-up. The results suggest that PFA using biphasic asymmetric waveforms for patients with AF is safe, durable, and effective and that a larger clinical trial could begin.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn/, identifier, ChiCTR2100051894.

摘要

未标注

脉冲场消融(PFA)是一种用于治疗心房颤动(AF)的新方法,其选择性消融特性使其在治疗中具有显著优势。在先前的细胞和动物实验中,我们已经证明双相不对称脉冲可用于消融心肌组织。然而,在进行大规模临床试验之前,需要小规模临床试验来测试这种方法是否安全可行。因此,本实验的目的是确定双相不对称脉冲在AF患者中的安全性和可行性,并为更大规模的临床试验奠定基础。使用双相不对称脉冲对10例AF患者进行消融。在PFA手术前后进行电压标测,以帮助我们检测肺静脉(PV)的电压变化。三维标测系统显示消融部位持续低电位,所有患者的4条PV均实现了肺静脉隔离(PVI)。在12个月的随访期间,无复发、PV狭窄或其他严重不良事件。结果表明,对AF患者使用双相不对称波形的PFA是安全、持久且有效的,并且可以开始更大规模的临床试验。

临床试验注册

https://www.chictr.org.cn/,标识符,ChiCTR2100051894。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/669a/10879394/0ca6079a87b9/fcvm-11-1266195-g001.jpg

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