Division of Cardiology, University of Basel Hospital, Basel, Switzerland.
Heart Rhythm. 2010 Dec;7(12):1770-6. doi: 10.1016/j.hrthm.2010.08.028. Epub 2010 Oct 12.
Cryoballoon ablation has emerged as a novel treatment strategy for patients with atrial fibrillation (AF).
The purpose of this study was to compare pulmonary vein isolation (PVI) using cryoballoon ablation versus RF ablation with regard to myocardial injury, pulmonary vein (PV) reconnection patterns, and outcome.
Fifty patients (age 59 ± 9 years, ejection fraction 0.59 ± 0.06, left atrial size 41 ± 5 mm) with paroxysmal AF were studied. Twenty-five patients underwent PVI using a 28-mm cryoballoon. A control group of 25 patients underwent PVI using an open-irrigation RF ablation catheter. Myocardial injury was determined by measuring troponin T (TnT). PV reconnection patterns were studied in case of repeat procedures.
Procedure duration was 166 ± 32 minutes in the cryoballoon group versus 197 ± 52 minutes in the RF group (P = .014), with similar ablation times (cryoballoon: 45 minutes [interquartile range 40-52.5 minutes]; RF: 47 minutes [interquartile range 44-65 minutes], P = .17). Postprocedural TnT in the RF group was 1.29 ± 0.41 μg/L versus 0.76 ± 0.55 μg/L in the cryoballoon group (P = .002). In 12 patients who underwent repeat ablation, 74% of PV reconnection sites were inferiorly located in the cryoballoon group compared to 17% in the RF group (P = .0004). With 1.2 ± 0.4 and 1.3 ± 0.6 procedures per patient, 88% of patients in the cryoballoon group and 92% in the RF group were in stable sinus rhythm after follow-up of 12 ± 3 months (P = NS).
Differences in the extent of myocardial injury and patterns of PV reconnection were observed between cryoballoon ablation and RF ablation of paroxysmal AF.
冷冻球囊消融术已成为治疗心房颤动（AF）患者的一种新的治疗策略。
本研究旨在比较冷冻球囊消融术与射频消融术在心肌损伤、肺静脉（PV）再连接模式和结果方面的差异。
50 例阵发性 AF 患者（年龄 59 ± 9 岁，射血分数 0.59 ± 0.06，左心房大小 41 ± 5mm）接受研究。25 例患者采用 28mm 冷冻球囊进行 PV 隔离（PVI）。对照组 25 例患者采用开放灌流射频消融导管进行 PVI。通过测量肌钙蛋白 T（TnT）来确定心肌损伤。在重复手术时研究 PV 再连接模式。
冷冻球囊组的手术时间为 166 ± 32 分钟，射频组为 197 ± 52 分钟（P =.014），消融时间相似（冷冻球囊：45 分钟[四分位间距 40-52.5 分钟]；射频：47 分钟[四分位间距 44-65 分钟]，P =.17）。射频组术后 TnT 为 1.29 ± 0.41μg/L，冷冻球囊组为 0.76 ± 0.55μg/L（P =.002）。在 12 例接受重复消融的患者中，74%的 PV 再连接部位位于冷冻球囊组，而射频组为 17%（P =.0004）。冷冻球囊组每例患者需要 1.2 ± 0.4 次和 1.3 ± 0.6 次手术，在随访 12 ± 3 个月后，冷冻球囊组 88%的患者和射频组 92%的患者处于稳定窦性节律（P = NS）。
在阵发性 AF 的冷冻球囊消融术与射频消融术之间观察到心肌损伤程度和 PV 再连接模式的差异。
