[消融治疗的技术原理]

Q4 Medicine Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2024-06-01 Epub Date: 2024-05-21 DOI:10.1007/s00399-024-01028-8
Felix Bourier
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引用次数: 0

摘要

导管消融术是现代心脏病学的标准程序。它能大大提高心律失常患者的生活质量和预期寿命。除了心脏图谱,消融本身也是成功治疗心律失常的基本步骤。目前有多种消融技术:在传统的射频(RF)消融中,电流会产生凝固性坏死。在了解射频消融的生物物理原理后,研究人员就能根据手术要求调整病灶的几何形状和大小,并对其进行个别调整。此外,病灶度量指数可评估和整合功率、持续时间、阻抗和接触力等重要参数,以规范和控制射频病灶。冷冻消融会在心肌组织内诱导冰晶,导致治疗组织的破坏和电瘢痕。从组织学角度看,冷冻灶界限清晰,组织结构和心内膜完好无损。脉冲场消融(PFA)是一种新型的新兴技术,尤其适用于肺静脉隔离。与传统的热技术(射频和低温消融)不同,脉冲场消融利用脉冲电场对心脏组织进行电穿孔,从而只对细胞造成损伤。
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[Technical principles of ablation therapy].

Catheter ablation is a standard procedure in modern cardiology. It can significantly improve the quality of life and life expectancy of cardiac arrhythmia patients. Besides cardiac mapping, ablation itself is a fundamental step to successfully treat cardiac arrhythmias. There are various ablation technologies at hand: In traditional radiofrequency (RF) ablation, electrical current flow generates coagulation necrosis. When understanding the biophysical principles of RF ablation, the investigator is capable to adapt lesion geometry and size to the requirements of the procedure and vary them individually. In addition, lesion metric indices evaluate and integrate important parameters such as power, duration, impedance and contact force to standardize and control RF lesions. Cryoablation induces ice crystals within myocardial tissue, which lead to destruction and electrical scarring of the treated tissue. Histologically, cryolesions are well-delineated with preserved tissue architecture and intact endocardium. Pulsed field ablation (PFA) is a novel rising technology, particularly used for pulmonary vein isolation. In contrast to classic thermal technologies (RF and cryoablation), PFA uses pulsed electrical fields to electroporate cardiac tissue and thereby creates damage on a cellular level only.

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来源期刊
Herzschrittmachertherapie und Elektrophysiologie
Herzschrittmachertherapie und Elektrophysiologie Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.10
自引率
0.00%
发文量
76
期刊介绍: Mit wissenschaftlichen Original- und Übersichtsarbeiten, Berichten über moderne Operationstechniken und experimentelle Methoden ist die Zeitschrift Herzschrittmachertherapie + Elektrophysiologie ein Diskussionsforum für Themen wie: - Zelluläre Elektrophysiologie - Theoretische Elektrophysiologie - Klinische Elektrophysiologie - Angewandte Herzschrittmachertherapie - Bradykarde und tachykarde Herzrhythmusstörungen - Plötzlicher Herztod und Risikostratifikation - Elektrokardiographie - Elektromedizinische Technologie - Experimentelle und klinische Pharmakologie - Herzchirurgie bei Herzrhythmusstörungen Mitteilungen der Arbeitsgruppen Herzschrittmacher und Arrhythmie der Deutschen Gesellschaft für Kardiologie - Herz und Kreislaufforschung e.V. (DGK) sowie Stellungnahmen und praktische Hinweise runden das breite Spektrum dieser Zeitschrift ab. Interessensgebiete: Kardiologie, Herzschrittmachertherapie, Herzschrittmachertechnologie, klinische Elektrophysiologie
期刊最新文献
[Controversies in rhythmology]. [Atrial fibrillation in combination with severe mitral regurgitation : Which should be treated first, the atrial fibrillation or the mitral valve?] [Initial ablation of atrial fibrillation-Is pulmonary vein isolation sufficient? : Pro and contra]. [(LV)EF is a poor predictor of sudden cardiac death : Pro/Contra]. Erratum zu: Herzrhythmusstörungen bei Erwachsenen mit angeborenen Herzfehlern.
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