灌注尖端导管技术治疗心律失常的研究进展。

Petr Peichl, Josef Kautzner
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引用次数: 9

摘要

没有主动冷却导管尖端的射频导管消融与血栓形成和血栓栓塞的风险显著增加相关,特别是当考虑多次和高能分娩时。因此,对于复杂心律失常的导管消融,远端电极的冲洗已成为必须的。冷却导管技术的进步旨在进一步降低电极和组织上蒸汽爆裂和凝固形成的风险,并最大限度地向组织传递能量。新型导管设计是否能提高导管消融的成功率和降低并发症的风险,还有待后续研究的评估。未来,新型传感器的结合有望实现对病变形成的在线监测。这种技术应该可以优化射频传输,而不会产生深层组织过热和蒸汽爆裂的风险。冲洗消融导管领域最近的专利主要集中在新型多孔材料上,这种材料可以在导管尖端周围漫射冲洗,并且可以选择冲洗孔的布局。此外,一些专利涉及到将灌洗液管和位于导管尖端的不同传感器组合在一起。
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Advances in irrigated tip catheter technology for treatment of cardiac arrhythmias.

Radiofrequency catheter ablation without active cooling of the catheter tip is associated with significantly increased risk of thrombus formation and thromboembolism, especially when multiple and high-energy deliveries are considered. Therefore, irrigation of the distal electrode has become obligatory for catheter ablation of complex cardiac arrhythmias. The advancement in the cooling catheter technology is aimed to further reduce the risk of steam pop as well as coagulum formation on both electrode and tissue, and to maximize energy transfer to the tissue. Whether novel catheter designs will translate into better success rates of catheter ablation and lower risk of complications remains to be evaluated by upcoming studies. In future, a combination with novel sensors that enable online monitoring of lesion creation is expected. Such technology should allow optimization of radiofrequency delivery without risk of deep tissue overheating and steam pop creation. Recent patents in the field of irrigated ablation catheter focus mainly on novel porous materials that would enable diffuse irrigation around the catheter tip and alternative layout of irrigation holes. Additionally, some patents deal with combination of irrigation fluid tubing and different sensors located within the catheter tip.

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