医学
室性心动过速
烧蚀
室间隔
内科学
导管消融
心脏病学
导管
胺碘酮
人口
外科
心房颤动
心室
环境卫生
作者
Petr Peichl,Alan Bulava,Dan Wichterle,Felix J.V. Schlösser,P Stojadinovic,E Borisincova,P Stiavnicky,Jana Hašková,Josef Kautzner
出处
期刊:Europace
[Oxford University Press]
日期:2024-07-01
卷期号:26 (7)
标识
DOI:10.1093/europace/euae192
摘要
Abstract Aims A pulsed electric field (PF) energy source is a novel potential option for catheter ablation of ventricular arrhythmias (VAs) as it can create deeper lesions, particularly in scarred tissue. However, very limited data exist on its efficacy and safety. This prospective observational study reports the initial experience with VA ablation using focal PF. Methods and results The study population consisted of 44 patients (16 women, aged 61 ± 14years) with either frequent ventricular premature complexes (VPCs, 48%) or scar-related ventricular tachycardia (VT, 52%). Ablation was performed using an irrigated 4 mm tip catheter and a commercially available PF generator. On average, 16 ± 15 PF applications (25 A) were delivered per patient. Acute success was achieved in 84% of patients as assessed by elimination of VPC or reaching non-inducibility of VT. In three cases (7%), a transient conduction system block was observed during PF applications remotely from the septum. Root analysis revealed that this event was caused by current leakage from the proximal shaft electrodes in contact with the basal interventricular septum. Acute elimination of VPC was achieved in 81% patients and non-inducibility of VT in 83% patients. At the 3-month follow-up, persistent suppression of the VPC was confirmed on Holter monitoring in 81% patients. In the VT group, the mean follow-up was 116 ± 75 days and a total of 52% patients remained free of any VA. Conclusion Pulsed electric field catheter ablation of a broad spectrum of VA is feasible with acute high efficacy; however, the short-term follow-up is less satisfactory for patients with scar-related VT.
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