Patient experience of very high power short duration radiofrequency ablation for atrial fibrillation under mild conscious sedation.
Patient experience of very high power short duration radiofrequency ablation for atrial fibrillation under mild conscious sedation.
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DOI：
10.1007/s10840-022-01351-5
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发表时间：
2023-03
影响因子：
1.8
通讯作者：
Gupta, Dhiraj
中科院分区：
文献类型：
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作者：
Chu, Gavin;Calvert, Peter;Sidhu, Bharat;Mavilakandy, Akash;Kotb, Ahmed;Tovmassian, Lilith;Kozhuharov, Nikola;Bierme, Cedric;Denham, Nathan;Pius, Charlene;O'Brien, Jim;Ding, Wern Yew;Luther, Vishal;Snowdon, Richard L.;Ng, G. Andre;Gupta, Dhiraj
极高功率短持续时间（vHPSD）射频消融（RFA）可缩短消融时间并提高患者耐受性，允许在轻度清醒镇静（mCS）下进行肺静脉隔离（PVI）并促进当天出院（SDD）。首先，在英国的2个三级心脏中心进行了一项回顾性可行性研究。将使用90 W损伤消融（持续4 s）的首次肺静脉隔离的连续病例与使用标准射频（sRF）和冷冻球囊（Cryo）治疗的病例进行比较。随后，对仅在mCS下接受vHPSD或冷冻的患者进行了前瞻性研究。使用基于Likert和视觉模拟量表（VAS）的问卷来测量焦虑、不适和疼痛。回顾性研究共纳入182例患者（59例vHPSD、62例sRF和61例Cryo），其中53例（90%）vHPSD病例在mCS下成功施行。vHPSD组的PVI消融时间（5.8 ± 1.7 min）短于sRF组（16.5 ± 6.3 min，p < 0.001）和Cryo组（17.5 ± 5.9 min，p < 0.001）。前瞻性研究纳入了51例vHPSD和52例冷冻患者。vHPSD组的肺静脉隔离消融时间短于冷冻组（6.4 ± 2.9 min vs 17.9 ± 5.7 min，p < 0.001），但总体手术持续时间较长（121 ± 39 min vs 95 ± 20 min，p < 0.001）。患者的焦虑、不适或疼痛体验无差异。两组的SDD率相同（61% vs 67%，p = 0.49）。可在mCS下进行PVI的vHPSD RFA，以实现与冷冻消融相当的SDD率，而不会影响患者体验。
Very high power short duration (vHPSD) radiofrequency ablation (RFA) may reduce ablation times and improve patient tolerability, permitting pulmonary vein isolation (PVI) under mild conscious sedation (mCS) and promoting same day discharge (SDD). First, a retrospective feasibility study was performed at 2 tertiary cardiac centres in the UK. Consecutive cases of first-time PVI using vHPSD ablation with 90 W lesions for up to 4 s were compared against cases performed using standard RF (sRF) and cryoballoon (Cryo) therapy. Subsequently, a prospective study of patients who had vHPSD or Cryo exclusively under mCS was undertaken. Questionnaires based on Likert and visual analogue scales (VAS) were used to measure anxiety, discomfort and pain. In total, 182 patients (59 vHPSD, 62 sRF and 61 Cryo) were included in the retrospective study, with 53 (90%) of vHPSD cases successfully performed under mCS. PVI ablation time in the vHPSD group (5.8 ± 1.7 min) was shorter than for sRF (16.5 ± 6.3 min, p < 0.001) and Cryo (17.5 ± 5.9 min, p < 0.001). Fifty-one vHPSD and 52 Cryo patients were included in the prospective study. PVI ablation time in the vHPSD group was shorter than for the Cryo group (6.4 ± 2.9 min vs 17.9 ± 5.7 min, p < 0.001), but overall procedure duration was longer (121 ± 39 min vs 95 ± 20 min, p < 0.001). There were no differences in the patient experience of anxiety, discomfort or pain. SDD rates were the same in both groups (61% vs 67%, p = 0.49). vHPSD RFA for PVI can be performed under mCS to achieve SDD rates comparable to cryoablation, without compromising patient experience.
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影响因子：
1.8
作者：
Bartoletti, Stefano;Mann, Mandeep;Gupta, Dhiraj
通讯作者：
Gupta, Dhiraj
影响因子：
2.9
作者：
Doyle C;Lennox L;Bell D
通讯作者：
Bell D
DOI：
10.1093/europace/eux275
发表时间：
2018-01-01
期刊：
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
影响因子：
--
作者：
Calkins H;Hindricks G;Cappato R;Kim YH;Saad EB;Aguinaga L;Akar JG;Badhwar V;Brugada J;Camm J;Chen PS;Chen SA;Chung MK;Nielsen JC;Curtis AB;Davies DW;Day JD;d'Avila A;de Groot NMSN;Di Biase L;Duytschaever M;Edgerton JR;Ellenbogen KA;Ellinor PT;Ernst S;Fenelon G;Gerstenfeld EP;Haines DE;Haissaguerre M;Helm RH;Hylek E;Jackman WM;Jalife J;Kalman JM;Kautzner J;Kottkamp H;Kuck KH;Kumagai K;Lee R;Lewalter T;Lindsay BD;Macle L;Mansour M;Marchlinski FE;Michaud GF;Nakagawa H;Natale A;Nattel S;Okumura K;Packer D;Pokushalov E;Reynolds MR;Sanders P;Scanavacca M;Schilling R;Tondo C;Tsao HM;Verma A;Wilber DJ;Yamane T
通讯作者：
Yamane T
DOI：
10.1007/s10840-012-9763-5
发表时间：
2013-09-01
影响因子：
1.8
作者：
Ezzat, Vivienne A.;Chew, Anastasia;Segal, Oliver R.
通讯作者：
Segal, Oliver R.
影响因子：
8.4
作者：
Di Biase, Luigi;Carlos Saenz, Luis;Natale, Andrea
通讯作者：
Natale, Andrea