Scar Dechanneling New Method for Scar-Related Left Ventricular Tachycardia Substrate Ablation

Scar Dechanneling New Method for Scar-Related Left Ventricular Tachycardia Substrate Ablation
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DOI:
10.1161/circep.114.002386
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发表时间:
2015-04-01
影响因子:
8.4
通讯作者:
Mont, Lluis
Mont, Lluis
中科院分区:
医学1区
文献类型:
--
作者:
Berruezo, Antonio;Fernandez-Armenta, Juan;Mont, Lluis

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室性心动过速(VT)的基底消融通常需要广泛的消融。瘢痕去血栓技术可能会限制消融的程度,方法和结果-该研究包括101例连续左心室瘢痕相关VT患者(75例缺血性患者;左心室射血分数,36+/-13%)。手术终点是通过消融CC入口消除所有识别的传导通道(CC),然后消除残留的诱导性VT。瘢痕消融本身使54.5%的患者无诱导性室性心动过速;消融残余诱导性室性心动过速使无诱导性室性心动过速增加至78.2%。仅需瘢痕去颤的患者手术时间较短(213+/-64和244+/-71分钟; P=0.027),射频应用较少(19+/-11%和27+/-18%; P=0.01),体外复律/除颤电击较少(20%和65.2%; P
Background-Ventricular tachycardia (VT) substrate ablation usually requires extensive ablation. Scar dechanneling technique may limit the extent of ablation needed.Methods and Results-The study included 101 consecutive patients with left ventricular scar-related VT (75 ischemic patients; left ventricular ejection fraction, 36+/-13%). Procedural end point was the elimination of all identified conducting channels (CCs) by ablation at the CC entrance followed by abolition of residual inducible VTs. By itself, scar dechanneling rendered noninducibility in 54.5% of patients; ablation of residual inducible VT increased noninducibility to 78.2%. Patients needing only scar dechanneling had a shorter procedure (213+/-64 versus 244+/-71 minutes; P=0.027), fewer radiofrequency applications (19+/-11% versus 27+/-18%; P=0.01), and external cardioversion/defibrillation shocks (20% versus 65.2%; P