心血管

订阅

MedSci主页 / 所有栏目 / 心血管

JACC：新型针管式导管消融方法治疗难治性室性心律失常

2019-04-04 不详 MedSci原创

心血管心律失常针管消融
关注

导管消融术对大部分药物难治性室性心律失常（VA）是有效的，然而对于部分异位起搏点位于心肌深处的VA来说，常规的心内膜和心外膜方法效果不佳，这类病人尚无有效治疗方法。本研究的目的旨在评估一种能够瞄准深部心律失常位点的新型可伸缩的27G针管的安全性和可行性。本研究纳入了31例之前至少接受过一次失败的导管消融术的持续性室性心律失常患者，对其进行了新型针管式消融，经过平均每个患者15针治疗后，73%的VT

导管消融术对大部分药物难治性室性心律失常（VA）是有效的，然而对于部分异位起搏点位于心肌深处的VA来说，常规的心内膜和心外膜方法效果不佳，这类病人尚无有效治疗方法。本研究的目的旨在评估一种能够瞄准深部心律失常位点的新型可伸缩的27G针管的安全性和可行性。

本研究纳入了31例之前至少接受过一次失败的导管消融术的持续性室性心律失常患者，对其进行了新型针管式消融，经过平均每个患者15针治疗后，73%的VT患者至少消除了一个异味心律失常位点，5例非持续性心律失常患者中4例出现周围性心律失常。经过平均6个月时间的随访，48%的患者无反复性的心律失常，另外19%的患者有所缓解。操作相关的并发症包括一例心包积液和非致死性的左心室起搏导联移位。

研究结果显示，对于药物和常规导管消融难治性室性心律失常患者，该新型针管式消融方法可改善患者预后，且风险可接受。

原始出处：

本文系梅斯医学(MedSci)原创编译整理，转载需授权！

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1854350, encodeId=35631854350a7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Nov 20 00:00:00 CST 2019, time=2019-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326171, encodeId=424713261e1d4, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1399626, encodeId=4cf213996268b, content=<a href='/topic/show?id=9a0546e31b5' target=_blank style='color:#2F92EE;'>#导管消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46731, encryptionId=9a0546e31b5, topicName=导管消融)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd042221840, createdName=wjcjjian, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421773, encodeId=be591421e7361, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528557, encodeId=1436152855e59, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=)]
    2019-11-20 hbwxf

    #JACC#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1854350, encodeId=35631854350a7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Nov 20 00:00:00 CST 2019, time=2019-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326171, encodeId=424713261e1d4, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1399626, encodeId=4cf213996268b, content=<a href='/topic/show?id=9a0546e31b5' target=_blank style='color:#2F92EE;'>#导管消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46731, encryptionId=9a0546e31b5, topicName=导管消融)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd042221840, createdName=wjcjjian, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421773, encodeId=be591421e7361, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528557, encodeId=1436152855e59, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=)]
    2019-04-06 12498568m50暂无昵称

    #ACC#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1854350, encodeId=35631854350a7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Nov 20 00:00:00 CST 2019, time=2019-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326171, encodeId=424713261e1d4, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1399626, encodeId=4cf213996268b, content=<a href='/topic/show?id=9a0546e31b5' target=_blank style='color:#2F92EE;'>#导管消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46731, encryptionId=9a0546e31b5, topicName=导管消融)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd042221840, createdName=wjcjjian, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421773, encodeId=be591421e7361, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528557, encodeId=1436152855e59, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=)]
    2019-04-06 wjcjjian

    #导管消融#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1854350, encodeId=35631854350a7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Nov 20 00:00:00 CST 2019, time=2019-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326171, encodeId=424713261e1d4, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1399626, encodeId=4cf213996268b, content=<a href='/topic/show?id=9a0546e31b5' target=_blank style='color:#2F92EE;'>#导管消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46731, encryptionId=9a0546e31b5, topicName=导管消融)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd042221840, createdName=wjcjjian, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421773, encodeId=be591421e7361, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528557, encodeId=1436152855e59, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=)]
    2019-04-06 xiangyuzhou972

    #消融#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1854350, encodeId=35631854350a7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Nov 20 00:00:00 CST 2019, time=2019-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326171, encodeId=424713261e1d4, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1399626, encodeId=4cf213996268b, content=<a href='/topic/show?id=9a0546e31b5' target=_blank style='color:#2F92EE;'>#导管消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46731, encryptionId=9a0546e31b5, topicName=导管消融)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd042221840, createdName=wjcjjian, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421773, encodeId=be591421e7361, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528557, encodeId=1436152855e59, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Apr 06 02:00:00 CST 2019, time=2019-04-06, status=1, ipAttribution=)]
    2019-04-06 freve

    #难治性#

    0

相关资讯

JAHA：不同手术方式对主动脉缩窄患者预后的影响

主动脉缩窄（COA）即使接受了合适的治疗也会发生血管功能不全，但COA的治疗方法对血管功能的影响尚不清楚。本研究的目的旨在评估和比较外科手术、球囊扩张（BD）和支架植入治疗COA对血管功能的影响。本研究纳入了75例COA患者（28例为外科手术，23例为BD，24例支架植入），患者入组时的年龄、COA严重程度、压差梯度和代谢水平相似，但接受治疗时的年龄不尽相同。系统性高血压、主动脉僵硬度、内皮功能和

JACC：前100例经导管二尖瓣置换术患者的随访研究

经导管二尖瓣置换术（TMVR）是一项发展迅速的技术，而接受TMVR治疗的患者的随访资料尚缺乏。本研究的目的旨在评估前100名接受TMVR治疗的患者的随访预后。本研究纳入了100例外科手术高风险二尖瓣反流患者，平均年龄 75.4±8.1岁，男性占69%。在这些患者中，严重心衰（66%）和左室功能不全（平均射血分数46.4±9.6%）的发生率较高。在TMVR过程中，无1例死亡，有1例心尖大出血，无急性

JAHA：NT-proBNP与房颤发生风险种族差异相关

黑种人的心血管疾病风险因素要多于白种人，但房颤的发生率却低于白种人，相反，白种人的心衰风险更低。在白人中，N末端前B型钠尿肽（NT-proBNP）水平较高，可预测房颤的发生，并在心室舒张压升高的情况下具有利尿作用，这可能为这些种族差异提供统一的解释。本研究纳入了4731名CHS临床研究中参与者（770名黑种人）和12418名ARIC临床研究的参与者（3091名黑种人），其中分别有1277名和125

JAHA：他汀类药物依从性降低的心梗患者死亡风险**

许多急性心梗（AMI）后的老年患者在他汀类药物的依从性方面有所变化，但其与死亡率的相关性尚不清楚。本研究纳入了101011名2008-2010年年龄≥66岁的AMI住院患者，并对患者AMI前180天和AMI后180天的他汀类药物依从性进行了评估，分为非常不依从、轻中度不依从和依从三类。经过平均18个月时间的随访，20%的患者依从性明显提高，16%有所降低，14%患者无论AMI前还是AMI后均为不依

JAHA：拒绝或中断他汀药物治疗的原因调查研究

许多应接受他汀类药物治疗的心血管疾病患者没有接受他汀治疗，本研究的目的旨在探究患者自述的未接受他汀药物治疗的原因。本研究纳入了PALM数据库中的5693名推荐接受他汀药物治疗的患者。调查结果发现，有1511名（26.5%）患者未接受他汀药物治疗，其中894名（59.2%）患者自述未提供他汀药物，153名（10.1%）患者主动拒绝他汀药物治疗，464名（30.7%）患者中断了他汀药物治疗。女性、黑种

JACC：PET/MRI在检测动脉炎症中的应用

动脉粥样硬化是一种慢性炎症疾病，但是尚缺乏动脉早期炎症的检测方法。本研究的目的旨在通过混合18F-氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描/磁共振成像（PET/MRI）方法检测血管炎症的可行性。本研究纳入了PESA临床研究中的755名（40-54岁，男性占83.7%）通过血管内超声检测有斑块的患者，并对其颈动脉、主动脉和股动脉进行了PET/MRI检测。最终，在48.2%的患者中检测到动脉炎