王振, 黄一林, 刘宝山, 张爱元. 脉冲电场消融治疗房颤的现状[J]. 心脏杂志, 2023, 35(2): 224-228. DOI: 10.12125/j.chj.202206041
    引用本文: 王振, 黄一林, 刘宝山, 张爱元. 脉冲电场消融治疗房颤的现状[J]. 心脏杂志, 2023, 35(2): 224-228. DOI: 10.12125/j.chj.202206041
    Zhen WANG, Yi-lin HUANG, Bao-shan LIU, Ai-yuan ZHANG. Current status of pulsed electric field ablation for atrial fibrillation[J]. Chinese Heart Journal, 2023, 35(2): 224-228. DOI: 10.12125/j.chj.202206041
    Citation: Zhen WANG, Yi-lin HUANG, Bao-shan LIU, Ai-yuan ZHANG. Current status of pulsed electric field ablation for atrial fibrillation[J]. Chinese Heart Journal, 2023, 35(2): 224-228. DOI: 10.12125/j.chj.202206041

    脉冲电场消融治疗房颤的现状

    Current status of pulsed electric field ablation for atrial fibrillation

    • 摘要: 目前,导管消融术(catheter ablation,CA)已成为国内外治疗药物难治性房颤患者的主要方法,尤其是肺静脉隔离术(pulmonary vein isolation,PVI),已成为CA治疗的基石。无论是导管的阻抗热损伤还是球囊的冷冻消融,两大能源仍存在膈神经损伤、心房食管瘘、心包填塞等不可逆的安全问题。脉冲电场消融(pulsed field ablation,PFA),作为一种电脉冲能源,是治疗心律失常最新的消融技术热点话题。PFA通过释放短时程、高电压的电脉冲能量对细胞产生不可逆电穿孔,导致细胞凋亡,对心肌造成不可逆的损伤,发挥肺静脉隔离的作用。其优点主要是避免冠状动脉、食管、肺静脉及膈神经等周围组织受到损伤,比常规房颤消融方法更具有效性及安全性。本文对PFA的特点展开综述,详细阐述其治疗房颤的优势。

       

      Abstract: Catheter ablation (CA) has become one of the main methods for treating patients with medically refractory AF at home and abroad and pulmonary vein isolation (PVI) is the most important cornerstone of CA. There are still irreversible safety problems such as phrenic nerve injury, atrial esophageal fistula and pericardial tamponade, both in impedance thermal injury of catheter and cryoablation of balloon. Pulsed field ablation (PFA), as a new type of electrical impulse energy, is a hotspot in the treatment of arrhythmia. Its principle is that short-duration and high-voltage electrical impulse energy is released to irreversible electroporation of cells, resulting in cell apoptosis and causing irreversible damage to the heart muscle, thereby isolating the pulmonary veins. It can protect coronary artery, esophagus, pulmonary vein, phrenic nerve and other surrounding tissues from injury, and is more effective and safe than conventional ablation in the process of pulmonary vein isolation in atrial fibrillation. In this paper, the characteristics of pulsed electric field ablation are reviewed and its advantages in the treatment of atrial fibrillation are explained.

       

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