Kurose Jun, Kiuchi Kunihiko, Fukuzawa Koji, Mori Shumpei, Ichibori Hirotoshi, Konishi Hiroki, Taniguchi Yayoi, Hyogo Kiyohiro, Imada Hiroshi, Suehiro Hideya, Nagamatsu Yu-Ichi, Akita Tomomi, Takemoto Makoto, Hirata Ken-Ichi, Shimoyama Shinsuke, Watanabe Yoshiaki, Nishii Tatsuya, Negi Noriyuki, Kyotani Katsusuke
Section of Arrhythmia Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine Chuo-ku Kobe city Japan.
Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine Chuo-ku Kobe city Japan.
J Arrhythm. 2018 Jan 13;34(2):158-166. doi: 10.1002/joa3.12025. eCollection 2018 Apr.
Rhythm outcomes after the pulmonary vein isolation (PVI) using the cryoballoon (CB) are reported to be excellent. However, the lesions after CB ablation have not been well discussed. We sought to characterize and compare the lesion formation after CB ablation with that after radiofrequency (RF) ablation.
A total of 42 consecutive patients who underwent PVI were enrolled (29 in the CB group and 13 in the RF group). The PVI lesions were assessed by late gadolinium enhancement magnetic resonance imaging 1-3 months after the PVI. The region around the PVs was divided into eight segments: roof, anterior-superior, anterior-carina, anterior-inferior, bottom, posterior-inferior, posterior-carina, and posterior-superior segment. The lesion width and lesion gap in each segment were compared between the two groups. Lesion gaps were defined as no-enhancement sites of >4 mm.
As compared to the RF group, the overall lesion width was significantly wider and lesion gaps significantly fewer at the anterior-superior segment of the left PV (LAS) and anterior-inferior segment of the right PV (RAI) in the CB group (lesion width: 8.2 ± 2.2 mm vs 5.6 ± 2.0 mm, = .001; lesion gap at LAS: 7% vs 38%, = .02; lesion gap at RAI: 7% vs 46%, = .006).
The PVI lesions after CB ablation were characterized by extremely wider and more continuous lesions than those after RF ablation.
据报道，使用冷冻球囊（CB）进行肺静脉隔离（PVI）后的节律结果非常好。然而，CB消融后的病变尚未得到充分讨论。我们试图对CB消融后的病变形成进行特征描述，并与射频（RF）消融后的病变形成进行比较。
连续纳入42例接受PVI的患者（CB组29例，RF组13例）。在PVI后1 - 3个月，通过延迟钆增强磁共振成像评估PVI病变。肺静脉周围区域分为八个节段：顶部、前上、前嵴、前下、底部、后下、后嵴和后上节段。比较两组各节段的病变宽度和病变间隙。病变间隙定义为大于4 mm的无强化部位。
与RF组相比，CB组左肺静脉（LAS）前上节段和右肺静脉（RAI）前下节段的总体病变宽度明显更宽，病变间隙明显更少（病变宽度：8.2±2.2 mm对5.6±2.0 mm，P = 0.001；LAS处病变间隙：7%对38%，P = 0.02；RAI处病变间隙：7%对46%）。
与RF消融后的PVI病变相比，CB消融后的PVI病变具有更宽且更连续的特点。
