摘要
目的探讨导管射频消融(RFCA)和冷冻球囊消融(CBA)对心房颤动(AF)行肺静脉电隔离(PVI)后早期复发(ERAF)的影响。方法选取2016年4月至2017年1月于郑州人民医院心内科就诊的AF患者86例,其中男性58例(67.4%),平均年龄52~73(61.7±9.8)岁,阵发性房颤(PAF)76例(88.4%)。所有患者均接受PVI术治疗AF。根据手术方法分成两组,每组各43例,RFCA组平均年龄54~73(63.4±9.2)岁,男性28例(65.1%),CBA组平均年龄52~71(60.1±10.2)岁,男性30例(69.8%)。术后3个月进行随访,对两组复发率进行统计学分析。结果经过90 d随访,共24例患者(27.9%)复发,其中RFCA组11例(25.6%),CBA组13例(30.2%),Kaplan-Meier生存分析得出两组复发率无统计学差异(Log-Rank:P=0.758)。Cox多因素分析表明,左房内径(LAD,P=0.017)和持续性房颤(PeAF,P=0.019)是CBA术后复发的独立危险因素,而LAD是RFCA术后复发的独立危险因素(P=0.023)。结论两组手术方法术后早期复发率无显著差异。LAD是RFCA术后早期复发的独立危险因素,而LAD和PeAF是CBA术后复发的独立危险因素。
Objective To discuss the influence of radiofrequency catheter ablation(RFCA) and cryoballoon ablation(CBA) on early recurrence of atrial fibrillation(ERAF) after pulmonary vein isolation(PVI). Methods The patients with atrial fibrillation(AF, n=86) were chosen from Department of Cardiovascular Medicine in People’s Hospital of Zhengzhou City from Apr. 2016 to Jan. 2017, among them 58(67.4%) were the male aged from 52 to 73(average age=61.7±9.8), and there were 76(88.4%) cases of paroxysmal atrial fibrillation(PAF). All patients were received PVI for treating AF, and then divided, according to operation methods, into 2 groups(each n=43). There were 28(65.1%) male cases aged from 54 to 73(average age=63.4±9.2) in RFCA group, and there were 30(69.8%) cased aged from 52 to 71(average age=60.1±10.2) in CBA group. The patients were followed up after PVI for 3 months, and recurrence rate was given a statistical analysis in 2 groups. Results After followed up for 90 d, there were totally 24(27.9%) cases of recurrence, and 11(25.6%) in RFCA group and 13(30.2%) in CBA group. The Kaplan-Meier survival analysis showed that the recurrence rate had no statistical difference between 2 groups(Log-Rank: P=0.758). The multi-factor Cox analysis showed that left atrial diameter(LAD, P=0.017) and persistent AF(PeAF, P=0.019) were the independent risk factors of recurrence after CBA, and LAD(P=0.023) was an independent risk factor of f recurrence after RFCA. Conclusion There is no significant difference in ERAF between 2 operation methods. LAD is an independent risk factor of ERAF after RFCA, and LAD and PeAF are the independent risk factors of ERAF after CBA.
作者
徐桂安
赵明虎
Xu Gui'an;Zhao Minghu(Department of Cardiovascular Medicine,People's Hospital of Zhengzhou City,Henan Province,Zhengzhou 450053,China)
出处
《中国循证心血管医学杂志》
2019年第10期1212-1215,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
阵发性房颤
导管射频消融
冷冻球囊消融
早期复发
Paroxysmal atrial fibrillation
Radiofrequency catheter ablation
Cryoballoon ablation
Recurrence
