Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #1665 Kong Jiang Road, Shanghai 200092, China.
J Interv Cardiol. 2020 Jun 25;2020:8615410. doi: 10.1155/2020/8615410. eCollection 2020.
The feasibility and safety of performing the combined procedure of catheter ablation (CA) and left atrial appendage closure (LAAC) for atrial fibrillation (AF) have been reported by observational studies without controls. The aim of this study was to compare the procedural and long-term outcomes of combined procedures with isolated CA or LAAC.
This study included patients who underwent combined CA and LAAC (combined group), CA alone (CA-only group), or LAAC alone (LAAC-only group). Propensity score matching was used to select controls from the CA-only and LAAC-only groups. Each group contained 76 subjects. The procedures were successfully performed in all the patients. Procedure-related complications of the combined group included one pericardial effusion and two groin haematomas, which did not differ significantly with those of the CA-only group (3.9% vs. 2.6%, =0.650) or the LAAC-only group (3.9% vs. 2.6%, =0.650), respectively. The AF-free rate of the combined group was comparable with that of the CA-only group after a mean of 2 years follow-up (67.1% vs. 69.7%, =0.727). Compared with the LAAC-only group, the combined group achieved similar complete occlusion rate at implant (94.7% vs. 93.4%) and at 45 days (82.9% vs. 85.5%). At the end of follow-up, ischemic stroke and bleeding events of the combined group were low (3.9%) and were comparable with those of the CA-only group (5.3%) and the LAAC-only group (2.6%).
The combination of AF-CA and LAAC is safe and efficacious compared with single procedures alone.
观察性研究报告了房颤（AF）导管消融（CA）和左心耳封堵（LAAC）联合手术的可行性和安全性，但没有对照。本研究旨在比较联合手术与单独 CA 或 LAAC 的手术过程和长期结果。
本研究纳入了接受联合 CA 和 LAAC（联合组）、单独 CA（CA 组）或单独 LAAC（LAAC 组）治疗的患者。采用倾向评分匹配从 CA 组和 LAAC 组中选择对照组。每组包含 76 例患者。所有患者均成功完成了手术。联合组的手术相关并发症包括 1 例心包积液和 2 例腹股沟血肿，与 CA 组（3.9% vs. 2.6%，=0.650）或 LAAC 组（3.9% vs. 2.6%，=0.650）相比差异无统计学意义。在平均 2 年的随访后，联合组的 AF 无复发率与 CA 组相当（67.1% vs. 69.7%，=0.727）。与 LAAC 组相比，联合组在植入时（94.7% vs. 93.4%）和 45 天时（82.9% vs. 85.5%）达到了相似的完全闭塞率。在随访结束时，联合组的缺血性卒中和出血事件发生率较低（3.9%），与 CA 组（5.3%）和 LAAC 组（2.6%）相当。
与单独手术相比，AF-CA 和 LAAC 的联合应用是安全有效的。
