摘要
目的探讨冷冻球囊消融治疗房颤的有效性、安全性和复发的危险因素。方法将114例房颤患者分为阵发性房颤组(n=61)和持续性房颤组(n=53)。所有患者均行环肺静脉冷冻球囊消融术,对持续性房颤患者额外行前庭区域扩大冷冻消融。分析两组手术操作时间、X线曝光时间、环肺静脉冷冻消融的即刻和长期成功率以及手术相关并发症。比较两组患者术后一年内房颤复发率及相关复发因素。结果两组肺静脉隔离即刻成功率均为100%。两组手术操作时间、X线曝光时间和术中肝素用量比较,差异有统计学意义(P<0.05)。两组均未出现严重并发症。随访12个月,阵发性房颤组和持续性房颤组房颤消融成功率分别为85.25%和81.13%(P=0.62)。房颤持续时间和左心房内径与持续性房颤的复发相关。结论冷冻球囊消融对阵发性和持续性房颤均有较高的有效性和安全性,消融前房颤持续时间和左心房内径是持续性房颤患者术后复发的独立危险因素。
Objective To investigate the efficacy,safety and recurrence risk factors of cryoballoon ablation for atrial fibrillation(AF).Methods One hundred and fourteen patients were divided into paroxysmal AF group(n=61)and persistent AF group(n=53).Circumferential pulmonary vein cryoablation(CPVC)was performed in all the patients,and persistent AF patients underwent pulmonary vein antrum cryoablation in addition.The operation time,X-ray exposure time,immediate and long-term success rate of CPVC,and procedure-related complications were analyzed in the two groups.The recurrence rate and related recurrence factors of AF within one year after operation were compared between the two groups.Results The immediate success rates of pulmonary vein isolation are both 100%in the two groups.There are significant differences of the operation time,X-ray exposure time and intraoperative heparin dosage between the two groups(P<0.05).No serious complication is found in either of the two groups.After 12 months of follow-up,the success rates of AF ablation in the paroxysmal and persistent AFgroups are 85.25%and 81.13%,respectively(P=0.62).AF duration and left atrial diameter(LAD)are associated with the recurrence of persistent AF.Conclusion Cryoballoon ablation is both effective and safe for patients with paroxysmal and persistent AF.AF duration and LAD before ablation are independent risk factors for postoperative recurrence in persistent AF patients.
作者
赵晓溪
李库林
尤华彦
郑杰
党时鹏
刘晓宇
王如兴
ZHAO Xiaoxi;LI Kulin;YOU Huayan;ZHENG Jie;DANG Shipeng;LIU Xiaoyu;WANG Ruxing(Department of Cardiology,Wuxi Peoples Hospital Affiliated to Nanjing Medical University,Wuxi Jiangsu 214023,China)
出处
《实用心电学杂志》
2023年第2期77-82,共6页
Journal of Practical Electrocardiology
基金
国家自然科学基金资助项目(81770331)。
关键词
房颤
冷冻球囊消融
肺静脉隔离
复发
atrial fibrillation
cryoballoon ablation
pulmonary vein isolation
recurrence
