一种新型球囊导管用于无麻醉下慢性心房颤动内部心脏复律的疗效

Efficacy of a new balloon catheter for internal cardioversion of chronic atrial fibrillation without anaesthesia.

作者信息

Alt E, Ammer R, Lehmann G, Schmitt C, Pasquantonio J, Schömig A

机构信息

Department of Cardiology, Deutsches Herzzentrum München, Klinik an der Technischen Universität, Germany.

出版信息

Heart. 1998 Feb;79(2):128-32. doi: 10.1136/hrt.79.2.128.

DOI:10.1136/hrt.79.2.128

PMID:9538303

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1728613/

Abstract

OBJECTIVE

To compare a new internal cardioversion system incorporated into a balloon guided catheter with a conventional two electrode system in patients with atrial fibrillation (AF).

DESIGN

Prospective study.

PATIENTS

74 patients with chronic AF treated by internal cardioversion.

MATERIALS

A 7.5 F balloon catheter with high energy electrode arrays each consisting of six 0.5 cm platinum rings. Brachial vein access enables one electrode array to be placed in the left pulmonary artery (distal pole) and the other at the lateral right atrial wall (proximal pole). The conventional two electrode system consists of 6 F electrodes placed in the proximal left pulmonary artery (anode) and the lower right atrium.

INTERVENTIONS

Internal cardioversion was performed by shocks delivered in 40 V incremental steps from an external defibrillator. Shocks were applied by the new device to 32 patients (group A) and by the conventional system to 42 patients (group B).

RESULTS

The groups differed with respect to system positioning (9.2 (7.3) upsilon 12.3 (8.1) minutes, p < 0.05) and fluoroscopy times (1.7 (1.0) v 3.3 (2.1) minutes, p < 0.01). Sinus rhythm was restored in 30 patients of group A and in 39 of group B (NS) with mean (SD) energy requirements of 8.4 (3.1) J and 7.2 (3.1) J, respectively (NS).

CONCLUSIONS

This new method of internal cardioversion has comparably high primary success rates and low sedation requirements with single and two lead systems.

摘要

目的

比较一种集成于球囊引导导管的新型心脏内转复系统与传统双电极系统用于心房颤动（AF）患者的效果。

设计

前瞻性研究。

患者

74例接受心脏内转复治疗的慢性AF患者。

材料

一根7.5F的球囊导管，带有高能电极阵列，每个阵列由六个0.5厘米的铂环组成。经肱静脉穿刺可将一个电极阵列置于左肺动脉（远端电极），另一个置于右心房侧壁（近端电极）。传统双电极系统由置于左肺动脉近端（阳极）和右心房下部的6F电极组成。

干预措施

通过外部除颤器以40V递增步长进行电击来实施心脏内转复。新装置对32例患者（A组）进行电击，传统系统对42例患者（B组）进行电击。

结果

两组在系统定位时间（9.2（7.3）对12.3（8.1）分钟，p<0.05）和透视时间（1.7（1.0）对3.3（2.1）分钟，p<0.01）方面存在差异。A组30例患者和B组39例患者恢复窦性心律（无显著性差异），平均（标准差）能量需求分别为8.4（3.1）J和7.2（3.1）J（无显著性差异）。