Looi Khang-Li, Gajendragadkar Parag, Taha Tamer, Elsik Maros, Scully Elizabeth, Heck Patrick, Fynn Simon, Virdee Munmohan, Begley David
Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, CB23 3RE, UK.
J Interv Card Electrophysiol. 2013 Jan;36(1):61-9; discussion 69. doi: 10.1007/s10840-012-9744-8. Epub 2012 Oct 25.
Catheter ablation for paroxysmal atrial fibrillation (PAF) is an effective treatment. Favourable outcomes at 6-12 months post-ablation have been reported using the multi-electrode catheter 'pulmonary vein ablation catheter (PVAC)' but little is known about longer term outcomes. There are also limited data on quality of life (QoL) post-atrial fibrillation (AF) ablation beyond 2 years of follow-up.
Two hundred three consecutive patients (77 % male, mean age 57.7 ± 11 years) who had a PAF ablation were included. Patients underwent conventional pulmonary vein isolation (PVI) (n = 128) or PVAC ablation (n = 75). Patients' symptoms were scored at baseline, at clinic follow-up and on questionnaire follow-up using the validated Canadian Cardiovascular Society Severity of AF (CCS-SAF) scale. The 'AF Effect on QualiTy of life' (AFEQT) questionnaire was used on questionnaire follow-up.
Mean questionnaire follow-up was 854 ± 176 days with 74 % response rate. The majority of patients (91.6 % overall) were highly symptomatic at baseline with CCS-SAF class 3 or 4 symptoms. CCS-SAF class on follow-up questionnaire decreased significantly from baseline for both groups (mean 1.69 ± 1.7 for PVAC and 1.45 ± 1.5 for PVI, p = 0.001 and p < 0.001, respectively) with no difference between groups (p = 0.52) and the majority being class 0 or 1 (59.9 % overall). Mean AFEQT questionnaire scores were similar between both groups (78.1 ± 25 vs. 82 ± 23, p = 0.35). Total procedure time was significantly shorter in the PVAC group (135 ± 54 vs. 178 ± 43 min, p < 0.001).
There was a comparable and significant improvement in QoL post-ablation in patients who underwent ablation using PVAC catheter and conventional techniques.
导管消融治疗阵发性心房颤动（PAF）是一种有效的治疗方法。使用多电极导管“肺静脉消融导管（PVAC）”进行消融后6 - 12个月的疗效良好，但关于长期疗效的了解甚少。关于心房颤动（AF）消融术后2年以上的生活质量（QoL）数据也有限。
纳入203例连续接受PAF消融的患者（男性占77%，平均年龄57.7±11岁）。患者接受传统肺静脉隔离术（PVI）（n = 128）或PVAC消融术（n = 75）。在基线、临床随访和问卷随访时，使用经过验证的加拿大心血管学会房颤严重程度（CCS - SAF）量表对患者症状进行评分。在问卷随访时使用“房颤对生活质量的影响”（AFEQT）问卷。
问卷平均随访时间为854±176天，回复率为74%。大多数患者（总体为91.6%）在基线时具有高度症状，CCS - SAF分级为3级或4级症状。两组随访问卷上的CCS - SAF分级均较基线显著降低（PVAC组平均为1.69±1.7，PVI组平均为1.45±1.5，p分别为0.001和p < 0.001），组间无差异（p = 0.52），且大多数为0级或1级（总体为59.9%）。两组的平均AFEQT问卷评分相似（78.1±25对82±23，p = 0.35）。PVAC组的总手术时间显著更短（135±54对178±43分钟，p < 0.001）。
使用PVAC导管和传统技术进行消融的患者，消融术后生活质量有相当且显著的改善。
