■到目前为止,在通过一种新形式的能量(例如通过脉冲场消融(PFA)进行电穿孔)消融肺静脉(PV)期间,没有关于高度局部化阻抗(LI)测量的信息。
■一名有阵发性心房颤动病史的55岁男子因肺静脉隔离(PVI)入院。使用新的多电极PFA导管(FARAWAVE™)进行手术。在能量输送之前,使用Rhythmia™系统构建了左心房的高密度图,而IntellaNAVMifi™OI导管用于评估4个PV的基线LI值。使用手动标签记录IntellaNAV™导管在PVI前后测量静脉各段LI值的确切位置。在PFA输送后,LI值显示出显著的变化(基线LI与124.3±5ΩPFA后96.8±6Ω,P<0.0001),平均绝对LI变化为27.5±7Ω,平均百分比LI变化为25.8±8%。PFA前和PFA后的平均LI值之间的差异为28.0±5、26.5±9、26.8±3和28.8±10Ω,前,后部,和PV的下部。
■这是急性表征的第一个实例,就LI下降而言,由新的PFA系统产生的窦病变。消融部位的局部阻抗变化似乎大于通过热能源获得的成功消融点处记录的变化。
UNASSIGNED: To date, no information is available on highly localized impedance (LI) measurements during the ablation of pulmonary veins (PVs) via a new form of energy such as electroporation by means of pulsed-field ablation (PFA).
UNASSIGNED: A 55-year-old man with a history of paroxysmal atrial fibrillation was admitted to our hospital for PV isolation (PVI). The procedure was performed with the new multi-electrode PFA catheter (FARAWAVE™). Before energy delivery, a high-density map of the left atrium was constructed with the Rhythmia™ system, while the IntellaNAV Mifi™ OI catheter was used to assess the baseline LI values of the four PVs. A manual tag was used to record the exact position where the IntellaNAV™ catheter measured the LI values for each segment of the vein before and after PVI. The LI values displayed a significant variation after PFA delivery (124.3 ± 5 Ω for baseline LI vs. 96.8 ± 6 Ω after PFA, P < 0.0001) with a mean absolute LI variation of 27.5 ± 7Ω and a mean percentage LI variation of 25.8 ± 8%. The differences between the average LI values pre- and post-PFA were 28.0 ± 5, 26.5 ± 9, 26.8 ± 3, and 28.8 ± 10 Ω for the superior, anterior, posterior, and inferior portions of the PV.
UNASSIGNED: This is the first instance of the acute characterization, in terms of LI drop, of antral lesions created by a new PFA system. Local impedance variations at ablation sites seem to be larger than those recorded at successful ablation spots obtained by means of thermal energy sources.