点状压力感知脉冲电场消融二尖瓣峡部操作要点与潜在风险OA

Mitral isthmus(MI)is an important linear target in the catheter ablation of persistent atrial fibrillation,offering unique advantages in interrupting reentrant circuits,modifying atrial substrate,and regulating triggers and autonomic nerve activity.However,due to its complex anatomy,variable myocardial thickness,and proximity to the coronary sinus and circumflex coronary artery,conventional radiofrequency ablation often fails to achieve stable and durable bidirectional conduction block.Point-by-point contact force-sensing pulsed field ablation achieves continuous,uniform linear lesions by providing real-time feedback on catheter-tissue contact,representing a promising technique for MI ablation.Clinical practice and literature research show that this approach offers advantages in acute block rate,procedure time,and perioperative safety,but potential risks-including coronary artery spasm,mechanical complications,and hemolysis-related acute kidney injury-require careful monitoring.Future research should focus on conducting prospective,multicenter,large-sample studies in addition to standardizing procedural protocols and optimizing perioperative management,further clarifying optimal operational parameters,suitable patient populations,and long-term effects,in order to provide evidence-based medical evidence for linear ablation of complex atrial fibrillation.