使用冷冻球囊进行阵发性心房颤动的肺静脉消融术外加上腔静脉电隔离的安全性和可行性：一项前瞻性研究的结果。
Safety and feasibility of electrical isolation of the superior vena cava in addition to pulmonary vein ablation for paroxysmal atrial fibrillation using the cryoballoon: lessons from a prospective study.
机构信息
Electrophysiology Unit, Maria Cecilia Hospital, Cotignola, RA, Italy.
Heart Rhythm Management Center, Postgraduate program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Laarbeeklaan 101, Brussels, Belgium.
出版信息
J Interv Card Electrophysiol. 2021 Mar;60(2):255-260. doi: 10.1007/s10840-020-00740-y. Epub 2020 Apr 6.
PURPOSE
The purpose of this study was to evaluate the feasibility and safety of superior vena cava (SVC) isolation in addition to standard pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB) in patients with paroxysmal atrial fibrillation.
METHODS
Thirty-seven consecutive patients that underwent CB ablation for paroxysmal atrial fibrillation (PAF) were prospectively enrolled in our study. After PVI the SVC was mapped for potentials. If the SVC exhibited electrical activity, isolation was achieved performing a single 180-s balloon application.
RESULTS
Regarding SVC isolation, 180-s freeze in the SVC could be completed in 32 (86.4%) patients, and 5 patients had at least 120 s of freezing application (13.5%). Real-time recording during SVC isolation was observed in 30 (81.0%) patients. The mean time to isolation was 36.9 ± 28.7 s and the temperature at isolation was - 33 (- 15 to - 40) °C. No cases developed persistent phrenic nerve palsy (PNP) or any other complication.
CONCLUSIONS
Superior vena cava isolation proved to be safe and feasible with the second generation cryoballoon in a prospective series of patients affected by PAF.
目的
本研究旨在评估在阵发性心房颤动患者中使用第二代冷冻球囊（CB）进行上腔静脉（SVC）隔离联合标准肺静脉隔离（PVI）的可行性和安全性。
方法
前瞻性纳入 37 例接受 CB 消融治疗阵发性心房颤动（PAF）的患者。完成 PVI 后，对 SVC 进行电生理标测。如果 SVC 显示有电活动，则通过单次 180 秒的球囊应用来实现 SVC 隔离。
结果
在 SVC 隔离方面，32 例（86.4%）患者可以完成 180 秒的冷冻，5 例患者进行了至少 120 秒的冷冻应用（13.5%）。在 30 例（81.0%）患者中观察到 SVC 隔离的实时记录。隔离时间的平均值为 36.9±28.7 秒，隔离时的温度为-33（-15 至-40）℃。无持续性膈神经麻痹（PNP）或任何其他并发症发生。
结论
在受 PAF 影响的前瞻性患者系列中，第二代冷冻球囊进行 SVC 隔离被证明是安全且可行的。
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