脉冲消融与射频消融治疗房颤的研究进展

韦 秋兰1, 巫 颖2
1、右江民族医学院研究生院
2、右江民族医学院附属西南医院心血管内科

摘要


导管消融是药物治疗无效心房颤动患者的一线治疗方案。传统射频消融通过热效应形成稳定消融灶，疗效
确切，更适配持续性房颤的基质改良，但存在组织热损伤、肺静脉狭窄等热损伤风险。脉冲消融作为新型非热消融
技术，通过高压脉冲诱导心肌不可逆电穿孔实现选择性损伤，在保证肺静脉隔离成功率与射频消融相当的前提下，
降低热相关严重并发症，但其存在溶血、冠脉痉挛、辐射暴露增加等特殊风险，且远期随访数据尚不充分。本文汇
总近五年国内外相关研究，系统对比两种术式的作用机制、围术期表现、近远期疗效及安全性。二者临床应用各有
优势、互为补充，需结合房颤类型、心房解剖及患者合并症个体化选用，未来仍需大样本长期研究完善脉冲消融的
远期循证证据。

关键词


脉冲消融；射频消融；心房颤动

全文:

PDF


参考


[1]Hitoshi Mori，Kato Ritsushi. Radiofrequency

Ablation for Atrial Fibrillation in the Pulsed Field Era -

Mechanisms, Principles, and Future Roles[J]. Circ J, 2025.

[2]Shinsuke Miyazaki. Pulsed Field Ablation for Atrial

Fibrillation in Japan: Current Status and Future Perspectives[J].

Circ Rep, 2026, 8(4): 531-536.

[3]Yi Liu, Chen Yuwei, Ren Qiang, et al. Atrial

fibrillation: from pathogenesis to novel treatment options[J].

Mol Biomed, 2025, 6(1): 144.

[4]Pierre Jais, Neuzil Petr, Scherr Daniel, et al. Pulsed

field vs radiofrequency ablation for paroxysmal atrial

fibrillation: the BEAT PAROX-AF trial[J]. Eur Heart J,

2026, 47(13): 1527-1537.

[5]Min-Soo Cho, Lee So-Ryoung, Black-Maier Eric,

et al. Complications associated with pulsed field ablation vs

radiofrequency catheter ablation of atrial fibrillation[J]. Heart

Rhythm, 2025, 22(9): 2194-2200.

[6]Mark-S Brahier, Friedman Daniel-J, Bahnson

Tristram-D, et al. Repeat catheter ablation for atrial

fibrillation[J]. Heart Rhythm, 2024, 21(4): 471-483.

[7]Ines Martins Esteves, de Pontes Vinicius-Bittar,

Trevisan Thierry, et al. Pulsed-Field Ablation Versus

Radiofrequency Ablation for Paroxysmal Atrial Fibrillation: A

Systematic Review and Meta-Analysis[J]. J Arrhythm, 2025,

41(4): e70158.

[8]Mohit-K Turagam, Neuzil Petr, Schmidt Boris, et al.

Safety and Effectiveness of Pulsed Field Ablation to Treat Atrial

Fibrillation: One-Year Outcomes From the MANIFEST-PF

Registry[J]. Circulation, 2023, 148(1): 35-46.

[9]Rasha Kaddoura, Abushanab Dina, Asaad Nidal.

Pulsed-field ablation versus radiofrequency or cryoballoon

thermal ablation in atrial fibrillation: a systematic review and

meta-analysis[J]. Postgrad Med J, 2025, 101(1198): 690-703.

[10]Michela Casella, Valeri Yari, Compagnucci Paolo, et

al. Cardiac biomarker temporal dynamics after radiofrequency

and pulsed field catheter ablation of atrial fibrillation[J]. Heart

Rhythm O2, 2025, 6(11): 1688-1695.

[11]Andrei Mihordea, Puiu Mihai, Simu Gelu, et al.

Radiofrequency, Cryoablation, and Pulsed Field Ablation

for Atrial Fibrillation: Mechanisms, Preclinical Evidence, and

Clinical Outcomes[J]. Biomedicines, 2026, 14(4).

[12]Jernej Stublar, Jarm Tomaz, Mattison Lars, et al.

Intracardiac electrogram analysis may allow for prediction

of lesion transmurality after pulsed field ablation of atria in a

porcine model[J]. Heart Rhythm O2, 2025, 6(3): 350-361.


Refbacks

  • 当前没有refback。