第二代冷冻消融技术

来源 :2014中国心电学论坛 | 被引量 : 0次 | 上传用户:mscspn
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冷冻球囊消融治疗心房颤动(简称房颤)逐渐成为导管消融治疗阵发性房颤(PAF)的重要手段之一.目前国内采用的冷冻球囊为第一代冷冻球囊(Arctic Front),而欧美国家已经开始使用第二代冷冻球囊(Arctic Front AdvanceTM)。笔者在德国学习期间深刻体会到第二代冷冻球囊更加“强力、迅速”完成肺静脉隔离,缩短了手术时间,提高了冷冻消融疗效。与第一代冷冻球囊相比,第二代冷冻球囊在器械设计方面的改进主要表现在下列几个方面:冷源能量释放孔由4孔增加到8孔,加快了冷源能量释放速度,并使得冷冻球囊表面温度一致率由47%提高到83%。与此同时,冷源的组织渗透能力明显提高,使用第二代冷冻球囊持续冷冻2.3分钟即可达到第一代球囊冷冻消融持续冷冻4分钟的冷冻深度。球囊表面有效冷源释放面由带状面改为半球面,增加了球囊有效冷冻面与肺静脉口部组织的接触面积,避免了第一代冷冻球囊消融术中PVI“缝隙”现象。球囊内芯伸缩杆距离由7mm缩小至2mm,增加了球囊前半部分的变形能力,提高了对肺静脉口部形态的适应性。冷冻输送鞘前端可折叠段的弯曲度由90°增加至135°,提高了导管的柔韧性,使得球囊更加容易与下肺静脉接触。
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