Tsukagoshi Yutsuki, Nakamura Keijiro, Kitano Shoma, Sahara Naohiko, Hara Hidehiko
Division of Cardiovascular Medicine Toho University Ohashi Medical Center Tokyo Japan.
J Arrhythm. 2025 Sep 11;41(5):e70185. doi: 10.1002/joa3.70185. eCollection 2025 Oct.
Low-power, long-duration (LPLD) ablation (≤ 25 W for ≥ 60 s with 30 mL/min irrigation) was applied to high-impedance (≥ 150 Ω) left ventricular summit PVC sites via the anterior interventricular vein. Power was escalated stepwise (10 W → 12 W → 15 W → 18 W) under strict safety criteria. Computer simulations demonstrated safe lesion formation at 20 W, whereas 30 W exceeded 100°C, predicting steam-pop risk. This approach achieved 66.7% acute success without complications, highlighting LPLD as a promising option for challenging high-impedance coronary venous ablation sites.
通过前室间静脉，将低能量、长时间（LPLD）消融（以30毫升/分钟的灌注速度，≤25瓦持续≥60秒）应用于高阻抗（≥150Ω）的左心室心尖室性早搏部位。在严格的安全标准下，功率逐步升高（10瓦→12瓦→15瓦→18瓦）。计算机模拟表明，20瓦时可安全形成损伤，而30瓦时超过100°C，预示有蒸汽泡风险。该方法取得了66.7%的急性成功率且无并发症，突出了LPLD作为具有挑战性的高阻抗冠状静脉消融部位的一种有前景的选择。
