Mugnai Giacomo, de Asmundis Carlo, Iacopino Saverio, Ströker Erwin, Longobardi Massimo, Negro Maria Claudia, De Regibus Valentina, Coutino-Moreno Hugo Enrique, Takarada Ken, Choudhury Rajin, de Torres Juan Pablo Abugattas, Storti Cesare, Brugada Pedro, Chierchia Gian-Battista
Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
Electrophysiology and Cardiac Pacing Unit, Istituto di Cura Città di Pavia, Pavia, Italy.
J Interv Card Electrophysiol. 2018 Apr;51(3):279-284. doi: 10.1007/s10840-018-0329-z. Epub 2018 Feb 14.
Acute pericarditis is a minor complication following atrial fibrillation (AF) ablation procedures. The aim of the study was to evaluate the incidence and clinical aspects of pericarditis following cryoballoon (CB) ablation of AF investigating a possible association with procedural characteristics and a possible relationship with post-ablation recurrences.
Four hundred fifty consecutive patients (male 73%, age 59.9 ± 11.2 years) with drug-resistant paroxysmal AF who underwent CB ablation as index procedure were enrolled. Exclusion criteria were any contraindication for the procedure including the presence of intracavitary thrombus and uncontrolled heart failure and contraindications to general anesthesia.
Acute pericarditis following CB ablation occurred in 18 patients (4%) of our study population. Pericardial effusion occurred in 14 patients (78%) and was mild/moderate. The total number of cryoapplications and the total freeze duration were significantly higher in patients with pericarditis compared with those without (respectively, p = 0.0006 and p = 0.01). Specifically, the number of applications and freeze duration in right inferior pulmonary vein were found significantly higher in patients with pericarditis (p = 0.007). The recurrence rate did not significantly differ between the two study groups (respectively, 16.7 vs 18.1%; p = 0.9).
The incidence of acute pericarditis following CB ablation in our study population accounted for 4% and was associated with both total freezing time and number of cryoapplications. The clinical course was favorable in all these patients and the occurrence of acute pericarditis did not affect the outcome during the follow-up period.
急性心包炎是心房颤动（AF）消融术后的一种轻微并发症。本研究旨在评估冷冻球囊（CB）消融AF后心包炎的发生率和临床特征，探讨其与手术操作特点的可能关联以及与消融术后复发的可能关系。
连续纳入450例作为首次手术接受CB消融的药物难治性阵发性AF患者（男性占73%，年龄59.9±11.2岁）。排除标准为该手术的任何禁忌症，包括心腔内血栓形成、未控制的心力衰竭以及全身麻醉的禁忌症。
在我们的研究人群中，CB消融后有18例患者（4%）发生急性心包炎。14例患者（78%）出现心包积液，且积液为轻度/中度。心包炎患者的冷冻总次数和总冷冻持续时间显著高于无心包炎患者（分别为p = 0.0006和p = 0.01）。具体而言，心包炎患者右下肺静脉的冷冻次数和冷冻持续时间显著更高（p = 0.007）。两个研究组的复发率无显著差异（分别为16.7%对18.1%；p = 0.9）。
在我们的研究人群中，CB消融后急性心包炎的发生率为4% , 且与总冷冻时间和冷冻次数均有关。所有这些患者的临床病程良好，急性心包炎的发生在随访期间不影响预后。
