TUhjnbcbe - 2021/8/28 2:29:00
TODAY今日发布ESCHeartFailureEarlyRecent,Apr10,今日发布01篇StrokeEarlyRecent,Apr10,今日发布02篇CirculationResearchEarlyRecent,Apr10,今日发布01篇ANNNONINVASELECTROEarlyRecent,Apr10,今日发布01篇JournalofCardiacSurgeryEarlyRecent,Apr10,今日发布01篇CATHETERCARDIOINTEEarlyRecent,Apr10,今日发布01篇ClinicalTransplantationEarlyRecent,Apr10,今日发布01篇JournalofCachexia,SarcopeniaandMuscleEarlyRecent,Apr10,今日发布01篇JournalofClinicalUltrasoundEarlyRecent,Apr10,今日发布01篇CirculationEarlyRecent,Apr10,今日发布02篇JAMAINTERNMEDEarlyRecent,Apr10,今日发布01篇HypertensionEarlyRecent,Apr10,今日发布05篇JAMAEarlyRecent,Apr10,今日发布05篇ESCHeartFailureEarlyRecent,Apr11,今日发布01篇ANNNONINVASELECTROEarlyRecent,Apr11,今日发布01篇RECOMMEND推荐阅读01心房颤动射频消融术围术期急性脑动脉栓塞成功再通2例ANNNONINVASELECTROArticleJinXu,YanaLi,etc.2小时前等58用户推荐阅读本文Toexplorethestrategyofacutecerebralarteryembolismafterradiofrequencycatheterablation(RFA)foratrialfibrillation(AF).ReportingtwocaseswithacutecerebralinfarctionafterRFAforAF.TwopatientswerebothwithAF,andintracardiacthrombuswasexcludedthroughtransesophagealechocardiogram(TEE)beforeprocedure.Approachofablation:circumferentialpulmonaryveinablationinleftatriumtoisolatepulmonaryveinpluslinearablationinthetopandbottomofleftatrium(BOXprocedure).TheybothreceivedDabigatranEtexilatemgtwicedaily,starting6hrafterablation.Symptomsofmajorstrokeappeared30hrafterablationinCase1.OcclusionwasdetectedinM1segmentoftheleftmiddlecerebralarterybyMRI2hraftersymptomsonset.Intravenousthrombolysiswasgivenimmediately.InCase2,thepatientpresentedsymptomsofmajorstroke34hrafterablationandocclusioninthebasilararterywasconfirmedbyMRI4.5hraftersymptomsonset.Althoughitwasbeyondthethrombolysistimewindow,mechanicalthrombectomywastaken7hrafterthesymptomsonset.Theculpritarterywassuccessfullyrevascularizedinbothcases.InCase1,NIHSSscorewasreducedfrom8(beforethrombolysis)to0(24hrafterthrombolysis).InCase2,NIHSSscoredecreasedfrom18(beforeembolectomy)to3(24hrafterembolectomy).Bothofthepatientsliveanormallifewithoutbrainfunctionimpairmentandhemorrhageuntilthelastfollow‐up.TimelyrecanalizationcouldattainedagoodcureeffectwhenacutestokewashappenedafterRFAforAF.探讨心房颤动（AF）射频消融（RFA）后急性脑动脉栓塞的治疗策略。报告2例房颤射频消融后急性脑梗死，2例均为房颤，术前经食道超声心动图（TEE）排除心内血栓。消融途径：左心房环肺静脉消融隔离肺静脉加左心房上下段线性消融（BOX术）。他们都接受了达比加群酯毫克，每天两次，从消融后6小时开始。病例1消融后30小时出现严重中风症状。症状出现后2小时，MRI检查发现左侧大脑中动脉M1段闭塞。立即静脉溶栓。在病例2中，患者在消融后34小时出现严重中风症状，症状出现后4.5小时MRI证实基底动脉闭塞。虽然已经超出了溶栓时间窗口，但在症状出现后7小时内进行了机械血栓切除术。两例均成功地重建了罪犯动脉。在病例1中，NIHSS评分从溶栓前的8分降至0分（溶栓后24小时）。在病例2中，NIHSS评分从18分（取栓前）降至3分（取栓后24小时）。两名患者在最后一次随访前均生活正常，无脑功能损害和出血。RFA治疗AF后出现急性脑卒中，及时再通可获得良好的疗效。扫描