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冷冻消融术在心脏手术患者房颤治疗中的应用:我们的中期结果。

Application of cryoablation for the treatment of atrial fibrillation in patients undergoing cardiac surgery: Our mid-term results.

作者信息

Arnaz Ahmet, Güllü A Ümit, Akyol Ahmet, Zencirci Ertuğrul, Şenay Şahin, Değirmencioğlu Aleks, Koçyiğit Muharrem, Alhan Cem

机构信息

Department of Cardiovascular Surgery, Acıbadem Mehmet Ali Aydınlar University, School of Medicine, İstanbul, Turkey.

Department of Cardiology, Acıbadem Mehmet Ali Aydınlar University, School of Medicine, İstanbul, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2018 Jan 9;26(1):8-13. doi: 10.5606/tgkdc.dergisi.2018.14908. eCollection 2018 Jan.

Abstract

BACKGROUND

In this study, we aimed to present mid-term results of concomitant argon-based cryoablation in patients undergoing cardiac surgery.

METHODS

Between August 2014 and May 2016, 33 patients (17 males, 16 females; mean age 63.9 years; range 45 to 82 years) underwent the Maze procedure using cryoablation for the treatment of atrial fibrillation during a concomitant open cardiac operation. Robot-assisted procedures were used in 12 patients. Biatrial or isolated left atrial ablation was performed according to the underlying pathology. The rhythm assessment with 12-lead electrocardiography and 24-hour Holter, and recordings of atrial fibrillation-related medications, stroke or other thromboembolic events were evaluated by the cardiologist at 3 and 12 months postoperatively.

RESULTS

Thirty patients (90.9%) were in sinus rhythm and three (9.1%) were in atrial fibrillation at the time of discharge. Cryoablation failed in three patients (n=2, 8.3% in isolated left atrial and n=1, 11.1% in biatrial group) following the operation in the mid-term. Among the patients, there was no in-hospital mortality and no major postoperative complications such as stroke, sepsis, renal failure requiring dialysis, and prolonged respiratory failure.

CONCLUSION

Concomitant surgical cryoablation is an effective method for the treatment of atrial fibrillation, when performed concomitantly with other cardiac surgical procedures and results in very low atrial fibrillation recurrence, even in robotic surgery.

摘要

背景

在本研究中,我们旨在展示心脏手术患者同期进行氩气冷冻消融术的中期结果。

方法

2014年8月至2016年5月期间,33例患者(17例男性,16例女性;平均年龄63.9岁;范围45至82岁)在同期心脏直视手术中采用冷冻消融术进行迷宫手术以治疗心房颤动。12例患者采用机器人辅助手术。根据潜在病理情况进行双房或孤立左房消融。术后3个月和12个月,由心脏病专家通过12导联心电图和24小时动态心电图进行心律评估,并记录与心房颤动相关的药物使用情况、中风或其他血栓栓塞事件。

结果

30例患者(90.9%)出院时为窦性心律,3例(9.1%)为心房颤动。中期随访发现3例患者冷冻消融失败(2例孤立左房消融患者,占8.3%;1例双房消融患者,占11.1%)。患者中无院内死亡,也无中风、败血症、需要透析的肾衰竭和延长的呼吸衰竭等重大术后并发症。

结论

同期手术冷冻消融术是治疗心房颤动的有效方法,与其他心脏手术同期进行时,即使在机器人手术中,心房颤动复发率也很低。

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