Publication: Validación de la fijación activa como referencia del sistema de navegación no fluoroscópica ensite® en la ablación de fibrilación auricular
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2017-02-16
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Universidad Complutense de Madrid
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Abstract
La fibrilación auricular es la arritmia más frecuente con una prevalencia de 4,4% en nuestro medio. Se debe a una activación rápida y caótica de las aurículas que impide la contracción auricular y genera una frecuencia cardiaca rápida. Aunque los mecanismos para su aparición son múltiples, en muchos de los pacientes el origen de la arritmia parece relacionarse con las venas pulmonares que drenan en la aurícula izquierda. En su interior es habitual encontrar focos de extrasistolia con una frecuencia de despolarización rápida que, al conducirse al cuerpo de la aurícula, pueden generar fragmentación del frente de activación y la aparición de microrrentradas, sustrato necesario para la formación y mantenimiento de la arritmia La fibrilación auricular se asocia a un aumento de la morbimortalidad de los pacientes que la padecen, debido fundamentalmente a que presentan un mayor riesgo de eventos embólicos y, en pacientes con cardiopatía, puede condicionar el empeoramiento de la situación clínica. El tratamiento farmacológico disponible hasta el momento tiene una eficacia limitada y asocia frecuentes efectos secundarios. La ablación de venas pulmonares es una alternativa no farmacológica eficaz para el control de estos pacientes, incluso en aquellos casos en los que ha fallado la medicación. La intervención busca producir un aislamiento eléctrico de las cuatro venas pulmonares de tal forma que la actividad ectópica que se genera en su interior no pueda transmitirse al cuerpo de la aurícula izquierda...
Atrial fibrillation is the most common arrhythmia with a prevalence of 4,4% in our population. It occurs as a result of a chaotic and fast activation of the atrium that generates a fast heart rate and the atrium contraction disappears. Although the mechanisms are multiple, in many patients the origin of arrhythmia seems to be related to the pulmonary veins that drain into the left atrium. Inside of them, it is common to find extrasystolia foci with a high rate of depolarization and, when they are conducted into the atrium, they can generate fragmentation in the activation front and the appearance of re-entrant waves, which are the necessary substrate for the inception and maintenance of the arrhythmia. Atrial fibrillation is associated with an increased rate of morbidity and mortality, due to a higher risk of embolic events and, in patients with heart disease, may condition a worsening of their clinical status. Drug treatment available has limited efficacy and is associated with frequent side effects. Pulmonary veins ablation is a not pharmacological alternative that may be effective for the control of these patients, even in those cases where the medication has failed. The intervention attempts to produce an electrical isolation of the four pulmonary veins, so that ectopic activity generated inside the vein could not be conducted to the left atrium...
Atrial fibrillation is the most common arrhythmia with a prevalence of 4,4% in our population. It occurs as a result of a chaotic and fast activation of the atrium that generates a fast heart rate and the atrium contraction disappears. Although the mechanisms are multiple, in many patients the origin of arrhythmia seems to be related to the pulmonary veins that drain into the left atrium. Inside of them, it is common to find extrasystolia foci with a high rate of depolarization and, when they are conducted into the atrium, they can generate fragmentation in the activation front and the appearance of re-entrant waves, which are the necessary substrate for the inception and maintenance of the arrhythmia. Atrial fibrillation is associated with an increased rate of morbidity and mortality, due to a higher risk of embolic events and, in patients with heart disease, may condition a worsening of their clinical status. Drug treatment available has limited efficacy and is associated with frequent side effects. Pulmonary veins ablation is a not pharmacological alternative that may be effective for the control of these patients, even in those cases where the medication has failed. The intervention attempts to produce an electrical isolation of the four pulmonary veins, so that ectopic activity generated inside the vein could not be conducted to the left atrium...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 09/02/2016