Mickelsen Steven, Dudley Ben, Treat Eric, Barela John, Omdahl John, Kusumoto Fred
University of New Mexico School of Medicine, Albuquerque, 87111, USA.
J Interv Card Electrophysiol. 2005 Apr;12(3):213-20. doi: 10.1007/s10840-005-0621-6.
We evaluated the prevalence, trends, outcomes and the general experience of physicians performing atrial fibrillation ablation (AF-ABL) in the United States (US).
AF-ABL is a non-pharmacological and potentially curative therapy for AF. Success rates for AF-ABL have been reported to be between 80 and 90%. Although there are numerous clinical trial addressing this therapy little is known about the general status of AF-ABL in clinical practice.
We administered a mailed survey to the physician members of a professional arrhythmia society (Heart Rhythm Society, formerly known as the North American Society of Pacing and Electrophysiology) who practiced in the US (n = 1843).
There were 304 responses, 66% (n = 204) performed ABL and 30% (n = 92) performed AF-ABL. The study group performed a total of 5,592 AF-ABL from 2000 to 2003, out of 72,575 total ABL procedures during the same time period. There was a four-fold increase in the number of AF-ABL between 2000 and 2003 (2000: 628 vs. 2003: 2,575). In the same period, the self-reported short and long-term success rates of AF-ABL improved an average of 18 +/- 4% (p < or = 0.001). In 2003 the average self-reported one-month, one-year, and two-year success rates were: 71 +/- 4%, 66 +/- 5%, 63 +/- 6% respectively. The predicted five-year success was 60 +/- 4%. The average procedure took 4.5 +/- 0.4 hours. Physicians reported that approximately 29 +/- 4% of their patents were potential candidates for AF-ABL.
AF-ABL is becoming a much more common procedure in the US. Over the last four years the perceived short and long term success rates of AF-ABL have improved. Success rates in this survey are 10 to 20% lower than those reported in the recent clinical trials.
我们评估了美国医生进行心房颤动消融术（AF-ABL）的患病率、趋势、结果及总体经验。
AF-ABL是一种用于治疗心房颤动的非药物且可能治愈的疗法。据报道，AF-ABL的成功率在80%至90%之间。尽管有许多临床试验涉及这种疗法，但对于AF-ABL在临床实践中的总体状况知之甚少。
我们向在美国执业的一个专业心律失常协会（心律协会，前身为北美起搏与电生理学会）的医生会员邮寄了一份调查问卷（n = 1843）。
共收到304份回复，66%（n = 204）的医生进行了消融术，30%（n = 92）的医生进行了AF-ABL。研究组在2000年至2003年期间共进行了5592例AF-ABL，同期总消融手术为72575例。2000年至2003年期间，AF-ABL的数量增加了四倍（2000年：628例 vs. 2003年：2575例）。在同一时期，自我报告的AF-ABL短期和长期成功率平均提高了18±4%（p≤0.001）。2003年，自我报告的平均1个月、1年和2年成功率分别为：71±4%、66±5%、63±6%。预测的5年成功率为60±4%。平均手术时间为4.5±0.4小时。医生报告称，他们约29±4%的患者是AF-ABL的潜在候选人。
在美国，AF-ABL正变得越来越常见。在过去四年中，AF-ABL的短期和长期成功率均有所提高。本调查中的成功率比近期临床试验报道的低10%至20%。
