Kết quả triệt đốt rối loạn nhịp nhĩ khởi phát từ xoang Valsalva bằng năng lượng sóng có tần số radio

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Tác giả: Đình Phong Phan, Tuấn Việt Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 612.01442 Human physiology

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2023

Mô tả vật lý: 168-173

Bộ sưu tập: Metadata

ID: 502440

Thêm vào giỏ

Đánh giá kết quả và tính an toàn của phương pháp triệt đốt bằng sóng có tần số radio điều trị cơn tim nhanh nhĩ/ngoại tâm thu nhĩ khởi phát từ xoang Valsalva. Kết quả: Trong thời gian từ 2014 đến 2023, 11 bệnh nhân (7 nữ, 4 nam, tuổi trung bình 52,6 ± 13,6) có các cơn tim nhanh nhĩ (9 BN) và ngoại tâm thu nhĩ (1 BN) khởi phát từ xoang Valsalva được triệt đốt thành công bằng năng lượng sóng có tần số radio tại Viện Tim mạch Việt Nam (9 BN), bệnh viện Đông Đô (1 BN) và bệnh viện Đại học Y Hà Nội (1 BN). Vị trí khởi phát từ xoang không vành ở 10 BN (91%) và xoang vành trái ở 1 BN (9%). Ghi điện thế sớm là phương pháp chủ yếu để xác định vị trí khởi phát tim nhanh nhĩ với thời gian hoạt hóa điện sớm 25 ± 14 ms tính từ khởi đầu sóng P'. Triệt đốt thành công ở 100% số ca ngay sau thủ thuật và không có trường hợp nào tái phát trong thời gian theo dõi sau thủ thuật. Thời gian thủ thuật là: 69,5 ± 16,8 phút, thời gian chiếu tia X là: 11,5 ± 5,5 phút. Thông số triệt đốt bao gồm nhiệt độ đích đạt được: 55-60 độ C
mức năng lượng: 15-40W. Không có biến chứng liên quan đến thủ thuật nào được ghi nhận. Kết luận: Triệt đốt bằng năng lượng sóng có tần số radio có hiệu quả và an toàn trong điều trị các cơn tim nhanh nhĩ/ngoại tâm thu nhĩ khởi phát từ xoang Valsalva.The aim was to study the preliminary result and safety of catheter ablation for AT/APCs originating from the aortic cusps at the Vietnam Heart Institute and other hospitals in Vietnam. Results: Between 2014 and 2023, 11 patients (7 women, 4 men, mean age 52.6 ± 13.6 years) with symptomatic atrial tachycardias (9 patients) or frequent atrial premature contactions (1 patient) originating from sinus of Valsalva was successfully ablated by radiofrequency energy at the Vietnam Heart Institute (9 patients), Dong Do hospital (1 patient) and Hanoi Medical University hospital (1 patient). The origin was from the non-coronary sinus in 10 patients (91%) and the left coronary sinus in 1 patient (9%). Early activation recording is the predominant method to locate the site of origin an early activation time of 25 ± 14 ms measured from the onset of the P' wave. Ablation was successful in 100% of cases immediately after the procedure and there were no cases of recurrence during the post-procedure follow-up period. Procedure time was 69.5 ± 16.8 minutes, X-ray exposure time was 11.5 ± 5.5 minutes. The ablation parameters include the target temperature achieved: 55-60 degrees Celsius with power level set from 15 to 40W. No procedure-related complications were noted. Conclusion: Ablation within the aortic sinus of Valsalva is safe and effective for the treatment of atrial arrhythmias.

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