Heart Rhythm Management Center, Universitair Ziekenhuis Brussel, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
J Interv Card Electrophysiol. 2021 Jun;61(1):87-93. doi: 10.1007/s10840-020-00788-w. Epub 2020 May 29.
The second-generation cryoballoon ablation (CB-A) has been proven to be safe and effective for pulmonary vein (PV) isolation. Little is known regarding the long-term outcome following CB-A ablation for paroxysmal atrial fibrillation (AF). The aim of the study was to evaluate the freedom from atrial arrhythmias during a 5-year follow-up period among consecutive patients having undergone PV isolation with the CB-A for paroxysmal AF METHODS AND RESULTS: A total of 208 consecutive patients having undergone index PV isolation using CB-A (138 males, 66%; mean age 59.0 ± 12.6 years) were included in our retrospective analysis. Follow-up was based on outpatient clinic visits including Holter electrocardiograms. Recurrence of atrial tachyarrhythmias was defined as a symptomatic or documented episode of > 30 s. At a median follow-up of 62 months, freedom from atrial arrhythmias after a single procedure was achieved in 57.2% of patients. Multivariate analysis demonstrated that obesity, left atrial diameter, and duration of symptoms before AF ablation were independent predictors of ATas recurrences. Major complications occurred in 2.4% of patients.
The present study found a 5-year single-procedure success rate of 57.2% following CB-A ablation procedure. Obesity, higher LA dimensions, and longer duration of symptoms before ablation independently predicted the outcome.
第二代冷冻球囊消融(CB-A)已被证明可安全有效地隔离肺静脉(PV)。对于阵发性心房颤动(AF),关于 CB-A 消融后的长期结果知之甚少。本研究的目的是评估连续接受 CB-A 行阵发性 AF 的 PV 隔离患者在 5 年随访期间无房性心律失常的情况。
共对 208 例连续接受 CB-A 行指数性 PV 隔离的患者(男性 138 例,占 66%;平均年龄 59.0±12.6 岁)进行了回顾性分析。随访基于门诊就诊,包括动态心电图监测。房性心动过速复发定义为>30s 的有症状或有记录的发作。在中位随访 62 个月时,单次消融后无房性心律失常的患者比例为 57.2%。多因素分析表明,肥胖、左心房直径和 AF 消融前症状持续时间是 ATas 复发的独立预测因素。
本研究发现,CB-A 消融术后 5 年的单步成功率为 57.2%。肥胖、较高的左心房直径和消融前症状持续时间较长是独立的预测因素。