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使用脉冲场能量进行导管消融:我们终于有了战胜心房颤动的魔杖了吗?

Catheter ablation using pulsed-field energy: Do we finally have the magic wand to defeat atrial fibrillation?

作者信息

Cristiano Ernesto, Ali Hussam, Celentano Eduardo, Cappato Riccardo

机构信息

Department of Cardiac Electrophysiology Complex Operational Unit, Humanitas Gavazzeni, Bergamo 24125, Lombardy, Italy.

Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni 20099, Milan, Italy.

出版信息

World J Cardiol. 2024 Dec 26;16(12):677-682. doi: 10.4330/wjc.v16.i12.677.

Abstract

Clinical outcomes of catheter ablation remain suboptimal in patients with atrial fibrillation (AF), particularly in those with persistent AF, despite decades of research, clinical trials, and technological advancements. Recently, pulsed-field ablation (PFA), a promising non-thermal technology, has been introduced to improve procedural outcomes. Its unique feature of myocardial selectivity offers safety advantages by avoiding potential harm to vulnerable adjacent structures during AF ablation. However, despite the global enthusiasm within the electrophysiology community, recent data indicate that PFA is still far from being a "magic wand" for addressing such a complex and challenging arrhythmia as AF. More progress is needed in mapping processes rather than in ablation technology. This editorial reviews relevant available data and explores future research directions for PFA.

摘要

尽管经过数十年的研究、临床试验和技术进步,但心房颤动(AF)患者的导管消融临床结果仍不尽人意,尤其是持续性AF患者。最近,脉冲场消融(PFA)作为一种有前景的非热技术被引入,以改善手术效果。其心肌选择性的独特特性通过在AF消融期间避免对脆弱的相邻结构造成潜在伤害而具有安全优势。然而,尽管电生理学界对此全球热情高涨,但最近的数据表明,PFA距离成为解决AF这种复杂且具有挑战性的心律失常的“魔杖”仍相去甚远。在标测过程中需要取得更多进展,而不是在消融技术方面。这篇社论回顾了相关可用数据,并探讨了PFA的未来研究方向。

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