Ling Tian-You, Jin Qi, Pan Wen-Qi, Zhang Ning, Lin Chang-Jian, Lee Hon-Chi, Wu Li-Qun
Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, MN.
Pacing Clin Electrophysiol. 2017 Oct;40(10):1067-1072. doi: 10.1111/pace.13157. Epub 2017 Sep 27.
We assessed the effectiveness and safety of cryoballoon ablation (CBA) in the Chinese population with paroxysmal atrial fibrillation (AF) with a 1-year follow-up and determined the association of early recurrence of atrial tachyarrhythmias (ERAT) with late recurrence (LR).
A total of 114 patients (age 61 ± 10 years, 78 males) with paroxysmal AF who underwent CBA were consecutively enrolled. After procedures, patients were observed for 3 days with continuous electrocardiogram monitoring in the hospital with routine follow-up visits at 3 months, 6 months, and 1 year. Documented atrial tachyarrhythmia >30 seconds was defined as recurrence. ERAT was defined as any recurrence during the first 3 months, and LR was recurrence between 3 and 12 months.
With the first 3 months as blanking period, 76% of patients were free of LR at 12 months. Five patients (4%) experienced complications, including phrenic nerve palsy, stroke, and groin complications. Forty-five percent of patients had ERAT in the first 3 months and 31% of patients had ERAT in the first 3 days. Patients with ERAT had higher LR rate (LRR) than those without ERAT (43% vs 8%, P < 0.001). The LRR of patients with ERAT only in the first 3 days was lower than those with ERAT both in the first 3 days and in 4-90 days (29% vs 64%, P = 0.036).
CBA was an effective and safe treatment option for paroxysmal AF. Patients with ERAT had higher LRR after CBA of AF. The time when ERAT occurred had an impact on LRR.
我们对中国阵发性心房颤动（AF）患者进行了为期1年的随访，评估了冷冻球囊消融术（CBA）的有效性和安全性，并确定了房性快速心律失常早期复发（ERAT）与晚期复发（LR）之间的关联。
连续纳入114例接受CBA治疗的阵发性AF患者（年龄61±10岁，男性78例）。术后，患者在医院进行3天的连续心电图监测，并在3个月、6个月和1年进行常规随访。记录到的房性快速心律失常>30秒定义为复发。ERAT定义为前3个月内的任何复发，LR定义为3至12个月之间的复发。
以前3个月为空白期，76%的患者在12个月时无LR。5例患者（4%）出现并发症，包括膈神经麻痹、中风和腹股沟并发症。45%的患者在前3个月出现ERAT，31%的患者在前3天出现ERAT。有ERAT的患者比没有ERAT的患者有更高的LR率（LRR）（43%对8%，P<0.001）。仅在前3天出现ERAT的患者的LRR低于在前3天和4至90天均出现ERAT的患者（29%对64%，P=0.036）。
CBA是阵发性AF的一种有效且安全的治疗选择。AF患者进行CBA后，有ERAT的患者有更高的LRR。ERAT发生的时间对LRR有影响。
