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脉冲场消融:全面更新

Pulsed Field Ablation: A Comprehensive Update.

作者信息

Ezzeddine Fatima M, Asirvatham Samuel J, Nguyen Duy T

机构信息

Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.

Department of Pediatric and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

出版信息

J Clin Med. 2024 Sep 1;13(17):5191. doi: 10.3390/jcm13175191.

DOI:10.3390/jcm13175191
PMID:39274404
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11396515/
Abstract

One of the recent advancements in the field of cardiac electrophysiology is pulsed field ablation (PFA). PFA is a novel energy modality that does not rely on thermal processes to achieve ablation which, in turn, results in limited collateral damage to surrounding structures. In this review, we discuss the mechanisms, safety, efficacy, and clinical applications of PFA for the management of atrial and ventricular arrhythmias. We also summarize the published pre-clinical and clinical studies regarding this new technology.

摘要

心脏电生理学领域最近的进展之一是脉冲场消融(PFA)。PFA是一种新型能量模式,它不依赖热过程来实现消融,进而对周围结构造成的附带损伤有限。在本综述中,我们讨论了PFA用于治疗心房和心室心律失常的机制、安全性、有效性及临床应用。我们还总结了已发表的关于这项新技术的临床前和临床研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b4f/11396515/fa9394956ed0/jcm-13-05191-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b4f/11396515/171a19e07291/jcm-13-05191-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b4f/11396515/2c30ee3e8e5f/jcm-13-05191-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b4f/11396515/1b0215d2e2a3/jcm-13-05191-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b4f/11396515/fa9394956ed0/jcm-13-05191-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b4f/11396515/171a19e07291/jcm-13-05191-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b4f/11396515/2c30ee3e8e5f/jcm-13-05191-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b4f/11396515/1b0215d2e2a3/jcm-13-05191-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b4f/11396515/fa9394956ed0/jcm-13-05191-g004.jpg

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Pulsed Field Ablation: A Comprehensive Update.脉冲场消融:全面更新
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引用本文的文献

1
Changes in heart rate variability parameters following pulsed-field ablation in patients with atrial fibrillation: A systematic review and meta-analysis HRV changes after pulsed-field ablation in AF.心房颤动患者脉冲场消融后心率变异性参数的变化:一项系统评价和荟萃分析 房颤患者脉冲场消融后的心率变异性变化。
Int J Cardiol Heart Vasc. 2025 Aug 13;60:101766. doi: 10.1016/j.ijcha.2025.101766. eCollection 2025 Oct.
2
Isolating the Superior Vena Cava and Right Atrial Appendage by Pulsed Field Ablation.通过脉冲场消融分离上腔静脉和右心耳。
JACC Case Rep. 2025 Jun 11;30(14):103634. doi: 10.1016/j.jaccas.2025.103634.
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本文引用的文献

1
Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study.MANIFEST-17K 研究中超过 17000 例房颤患者应用脉冲场消融的安全性。
Nat Med. 2024 Jul;30(7):2020-2029. doi: 10.1038/s41591-024-03114-3. Epub 2024 Jul 8.
2
Comparative Efficacy and Safety of Pulsed Field Ablation Versus Radiofrequency Ablation of Idiopathic LV Arrhythmias.对比特发性左心室心律失常的脉冲场消融与射频消融的疗效和安全性。
JACC Clin Electrophysiol. 2024 Sep;10(9):1998-2009. doi: 10.1016/j.jacep.2024.04.025. Epub 2024 Jun 12.
3
Superior vena cava isolation using a pentaspline pulsed-field ablation catheter: feasibility and safety in patients undergoing atrial fibrillation catheter ablation.
Comparative Studies of Different Ablation Techniques for Atrial Fibrillation.
心房颤动不同消融技术的比较研究
Rev Cardiovasc Med. 2025 May 20;26(5):33490. doi: 10.31083/RCM33490. eCollection 2025 May.
4
Simulation of electroporation threshold based on the evolution of transmembrane potential and pore density.基于跨膜电位和孔密度演变的电穿孔阈值模拟
PeerJ. 2025 Apr 28;13:e19356. doi: 10.7717/peerj.19356. eCollection 2025.
使用五样条脉冲场消融导管进行上腔静脉隔离:在接受房颤导管消融的患者中的可行性和安全性
Europace. 2024 Jul 2;26(7). doi: 10.1093/europace/euae160.
4
Periprocedural Intravascular Hemolysis During Atrial Fibrillation Ablation: A Comparison of Pulsed Field With Radiofrequency Ablation.经皮腔内血管内溶血在心房颤动消融术中:脉冲场消融与射频消融的比较。
JACC Clin Electrophysiol. 2024 Jul;10(7 Pt 2):1660-1671. doi: 10.1016/j.jacep.2024.05.001. Epub 2024 May 16.
5
Comparison of cerebral safety after atrial fibrillation using pulsed field and thermal ablation: Results of the neurological assessment subgroup in the ADVENT trial.比较脉冲场和热消融治疗心房颤动后脑安全:ADVENT 试验神经评估亚组结果。
Heart Rhythm. 2024 Nov;21(11):2103-2109. doi: 10.1016/j.hrthm.2024.05.048. Epub 2024 May 31.
6
Preclinical Study of Pulsed Field Ablation of Difficult Ventricular Targets: Intracavitary Mobile Structures, Interventricular Septum, and Left Ventricular Free Wall.经导管脉冲电场消融治疗心室内复杂靶点的临床前研究:心室内可移动结构、室间隔和左心室游离壁。
Circ Arrhythm Electrophysiol. 2024 Jun;17(6):e012734. doi: 10.1161/CIRCEP.124.012734. Epub 2024 May 16.
7
Hemolysis After Pulsed Field Ablation: Impact of Lesion Number and Catheter-Tissue Contact.脉冲场消融后的溶血:消融灶数量及导管与组织接触的影响
Circ Arrhythm Electrophysiol. 2024 Jun;17(6):e012765. doi: 10.1161/CIRCEP.124.012765. Epub 2024 Apr 23.
8
Pulsed field ablation technology for pulmonary vein and left atrial posterior wall isolation in patients with persistent atrial fibrillation.脉冲场消融技术在持续性心房颤动患者肺静脉和左心房后壁隔离中的应用。
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Pulsed Field Ablation Index-Guided Ablation for Lesion Formation: Impact of Contact Force and Number of Applications in the Ventricular Model.脉冲场消融指数指导下的消融致病变形成:接触力和应用次数对心室模型的影响。
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Heart Rhythm. 2024 Apr;21(4):389-396. doi: 10.1016/j.hrthm.2023.12.017. Epub 2023 Dec 28.