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目的 对比二代冷冻球囊消融(Cryoballoon Ablation
CBA)与消融指数(Ablation index
AI)指导下的射频导管消融(Radiofrequency Ablation
RFA)对阵发性心房颤动患者的疗效,并探讨两种消融方式术后早期(1月内)房性心律失常(Early atrial arrhythmias
EA)对复发的预测价值。方法 入选2020年5月至2022年8月于马鞍山市人民医院接受CBA(n=31)和AI指导下RFA(n=32)治疗的阵发性房颤(Paroxysmal atrial fibrillation
PAF)患者进行分析,对比两组患者基线资料、手术参数、并发症和随访资料,评估两种消融方式治疗PAF的疗效以及术后EA对复发的预测价值。结果 (1)术后平均随访时间(13.7±3.2)个月,CBA组及RFA组术后分别有5例(16.1%)和6例(18.8%)房颤复发,无显著性差异(P>0.05);(2)CBA组与RFA组比较,EA预测术后房颤复发具有较高的敏感性、特异性和准确性(80.0%vs. 50.0%、76.9%vs. 57.7%、77.4%vs.56.3%)。CBA组术后早期房性心律失常对术后无复发率的影响存在统计学差异(Log Rank P=0.034),而RFA组无显著性差异(Log Rank P=0.562)。结论 阵发性房颤患者冷冻球囊消融及消融指数指导下的射频导管消融均是安全有效的;冷冻球囊消融术后早期房性心律失常对术后复发具有更高的预测价值。
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Radiofrequency versus cryoballoon ablation for atrial fibrillation: an argument for a 'cryo-first' approach.[J]. Tomaiko Emrie;Tseng Andrew;Su Wilber W.Current opinion in cardiology,2020
Cryoballoon or Radiofrequency Ablation for Atrial Fibrillation Assessed by Continuous Monitoring: A Randomized Clinical Trial.[J]. Andrade Jason G;Champagne Jean;Dubuc Marc;Deyell Marc W;Verma Atul;Macle Laurent;Leong-Sit Peter;Novak Paul;Badra-Verdu Mariano;Sapp John;Mangat Iqwal;Khoo Clarence;Steinberg Christian;Bennett Matthew T;Tang Anthony S L;Khairy Paul.Circulation,2019
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