高功率短时程消融在心房颤动治疗中的经验与困惑

Experience and confusion in the treatment of atrial fibrillation by high power short duration ablation

导管消融在心房颤动治疗中的价值日益凸显,但总体疗效仍不尽如人意,高功率短时程(HPSD)消融是近年来提出的新策略,消融功率高,损伤灶浅而宽大,有助于提升肺静脉隔离的成功率;消融时间短,手术效率高并减少卒中发生,减轻心脏负荷。然而,高功率消融操作窗口窄,参数的细微变化即可影响损伤灶形成。本文以HPSD消融为中心,系统阐述HPSD消融的理论及其在心房颤动治疗中的经验与困惑,并对未来进行展望。

The value of catheter ablation in the treatment of atrial fibrillation has become increasingly prominent,but the overall efficacy is still unsatisfactory,High power short duration(HPSD)ablation is a new strategy proposed in recent years.High ablation power produces shallow and wide lesions improve to the success rate of pulmonary vein isolation.The ablation time is short,the surgical efficiency is high,the occurrence of stroke is reduced,and the load on the heart is reduced.However,the high power ablation operation window is narrow,and the slight change of parameters can affect the formation of the lesion.Focusing on the ablation of HPSD,this paper systematically expounds the theory of HPSD ablation and the experience and confusion of HPSD ablation in the treatment of atrial fibrillation,and looks forward to the future.