Akhtar Tauseef, Berger Ronald, Marine Joseph E, Daimee Usama A, Calkins Hugh, Spragg David
Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, US.
Arrhythm Electrophysiol Rev. 2020 Aug;9(2):104-107. doi: 10.15420/aer.2020.18.
A significant proportion of AF patients with advanced age are being treated in clinical practice. Cryoballoon ablation of AF, given its shorter procedure time and comparable efficacy to radiofrequency ablation, has rapidly become a commonly used tool for AF ablation. Data regarding the outcomes of cryoballoon ablation of AF in octogenarians are limited because of the exclusion of this age group in the previous studies. The authors report outcomes of 15 octogenarian AF patients undergoing index cryoballoon ablation at a single centre. The mean age of the included patients was 83 ± 3 years. In total, 13 patients (87%) presented with paroxysmal AF, and two (13%) had long-standing persistent AF. At 6 and 12 months of follow-up, freedom from AF was 80% and 70%, respectively. None of the patients suffered any procedure-related complications. Cryoballoon ablation appears to be a safe and effective approach for treating symptomatic AF refractory to antiarrhythmic drug therapy in octogenarian patients, based on outcomes in this cohort. These findings require further validation in prospective randomised studies with larger sample sizes.
在临床实践中，很大一部分高龄房颤患者正在接受治疗。冷冻球囊消融房颤，因其手术时间较短且疗效与射频消融相当，已迅速成为房颤消融常用的手段。由于既往研究排除了该年龄组，关于80岁及以上老人房颤冷冻球囊消融结果的数据有限。作者报告了在单一中心接受首次冷冻球囊消融的15例80岁及以上房颤患者的结果。纳入患者的平均年龄为83±3岁。总共13例患者（87%）表现为阵发性房颤，2例（13%）为长期持续性房颤。在随访6个月和12个月时，无房颤的比例分别为80%和70%。没有患者出现任何与手术相关的并发症。基于该队列的结果，冷冻球囊消融似乎是治疗80岁及以上患者中对抗心律失常药物治疗无效的有症状房颤的一种安全有效的方法。这些发现需要在更大样本量的前瞻性随机研究中进一步验证。
