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心房颤动消融的学习曲线——第二代冷冻球囊与接触力感知射频导管的比较。

Learning curves in atrial fibrillation ablation - A comparison between second generation cryoballoon and contact force sensing radiofrequency catheters.

作者信息

Velagic Vedran, Prepolec Ivan, Pasara Vedran, Puljevic Mislav, Puljevic Davor, Planinc Ivo, Samardzic Jure, Milicic Davor

机构信息

University of Zagreb School of Medicine, Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Zagreb, Croatia.

University of Zagreb School of Medicine, Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Zagreb, Croatia.

出版信息

Indian Pacing Electrophysiol J. 2020 Nov-Dec;20(6):273-280. doi: 10.1016/j.ipej.2020.09.003. Epub 2020 Sep 30.

DOI:10.1016/j.ipej.2020.09.003
PMID:33007406
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7691769/
Abstract

OBJECTIVE

To examine the learning curves of atrial fibrillation (AF) ablation comparing the cryoballoon (CB) and radiofrequency (RF) catheters.

METHODS

We performed a retrospective data analysis from the initiation of AF ablation program in our center. For CB ablation, a second generation 28 mm balloon was utilized and for RF ablation.

RESULTS

A total of 100 consecutive patients (50 in each group) have been enrolled in the study (male 74%, mean age 58.9 ± 10 years, paroxysmal AF 85%). The mean procedure time was shorter for CB (116.6 ± 39.8 min) than RF group (191.8 ± 101.1 min) (p < 0.001). There was no difference in the mean fluoroscopy time, 24.2 ± 10.6 min in RF and 22.4 ± 11.7 min in CB group, (p = 0.422). Seven major complications occurred during the study; 5 in RF group (10%) and 2 in CB group (4%) (p = 0.436). After the mean follow up of 14.5 ± 2.4 months, 15 patients in RF group (30%) and 11 in CB group (26%) experienced AF recurrences (P = 0.300).

CONCLUSION

When starting a new AF ablation program, our results suggest that CB significantly shortens procedure while fluoroscopy time and clinical outcomes are comparable to RF ablation.

摘要

目的

比较冷冻球囊(CB)和射频(RF)导管在心房颤动(AF)消融中的学习曲线。

方法

我们对本中心启动AF消融项目以来的数据进行了回顾性分析。CB消融采用第二代28mm球囊,RF消融采用[此处原文未提及RF消融具体使用的设备,翻译时保留原文格式]。

结果

共有100例连续患者(每组50例)纳入本研究(男性占74%,平均年龄58.9±10岁,阵发性AF占85%)。CB组的平均手术时间(116.6±39.8分钟)短于RF组(191.8±101.1分钟)(p<0.001)。两组的平均透视时间无差异,RF组为24.2±10.6分钟,CB组为22.4±11.7分钟(p = 0.422)。研究期间发生了7例主要并发症;RF组5例(10%),CB组2例(4%)(p = 0.436)。平均随访14.5±2.4个月后,RF组有15例患者(30%)发生AF复发,CB组有11例患者(26%)发生AF复发(P = 0.300)。

结论

在启动新的AF消融项目时,我们的结果表明,CB显著缩短了手术时间,而透视时间和临床结果与RF消融相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/7b1d76eb86ee/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/8cbb619a01a3/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/d750f73e9706/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/0e9c5469e91c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/a101524af1b4/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/288746eff104/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/7b1d76eb86ee/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/8cbb619a01a3/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/d750f73e9706/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/0e9c5469e91c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/a101524af1b4/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/288746eff104/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19b1/7691769/7b1d76eb86ee/gr6.jpg

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Outcomes of cryoballoon or radiofrequency ablation in symptomatic paroxysmal or persistent atrial fibrillation.冷冻球囊或射频消融治疗症状性阵发性或持续性心房颤动的结果。
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Cryoballoon vs. radiofrequency ablation for atrial fibrillation: a study of outcome and safety based on the ESC-EHRA atrial fibrillation ablation long-term registry and the Swedish catheter ablation registry.
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