血液透析患者心房颤动冷冻球囊消融与射频导管消融的比较
Comparison between cryoballoon ablation and radiofrequency catheter ablation for atrial fibrillation in patients on hemodialysis.
作者信息
Hayashi Takahiro, Murakami Masato, Yokota Shohei, Yamada Takashi, Mashimo Yuka, Miyashita Hirokazu, Yokoyama Hiroaki, Ochiai Tomoki, Nishimoto Takashi, Yamaguchi Masashi, Moriyama Noriaki, Yamagishi Tamiharu, Tobita Kazuki, Shishido Koki, Mizuno Shingo, Yamanaka Futoshi, Tanaka Yutaka, Takahashi Saeko, Saito Shigeru
机构信息
Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan.
Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan.
出版信息
Indian Pacing Electrophysiol J. 2021 Mar-Apr;21(2):67-72. doi: 10.1016/j.ipej.2021.02.002. Epub 2021 Feb 6.
BACKGROUND
Difficulties are often encountered while controlling atrial fibrillation (AF), especially in hemodialysis (HD) patients. Previous data revealed that cryoballoon ablation (CBA) for treating paroxysmal atrial fibrillation (PAF) was not inferior to radiofrequency ablation (RFA); however, HD patients were excluded in this prior trial. Thus, the efficacy of CBA for HD patients is still unknown.
METHODS
This retrospective study analyzed HD patients who underwent catheter ablation (CA) for AF from August 2011 to June 2019. Patients who received CBA (CBA group) and those who received RFA (RFA group) were compared. The primary endpoint was defined as freedom from a composite outcome (a documented recurrence of any atrial tachyarrhythmia or a prescription of antiarrhythmic drugs) at one year after CA.
RESULTS
The RFA and CBA groups were composed of 21 and 23 patients, respectively. Freedom from a composite outcome was 58.4% in the RFA group and 68.2% in the CBA group (Log-rank: p = 0.571).
CONCLUSION
Our results suggest that patients on HD with AF who were treated with CBA tended to have better outcomes than patients treated with RFA. Therefore, CBA could be a suitable ablation method for HD patients.
背景
控制心房颤动（AF）时常常遇到困难，尤其是在血液透析（HD）患者中。先前的数据显示，冷冻球囊消融（CBA）治疗阵发性心房颤动（PAF）并不逊色于射频消融（RFA）；然而，先前的试验排除了HD患者。因此，CBA对HD患者的疗效仍然未知。
方法
这项回顾性研究分析了2011年8月至2019年6月期间接受房颤导管消融（CA）的HD患者。比较了接受CBA的患者（CBA组）和接受RFA的患者（RFA组）。主要终点定义为CA后一年无复合结局（记录到任何房性快速性心律失常复发或开具抗心律失常药物处方）。
结果
RFA组和CBA组分别由21例和23例患者组成。RFA组无复合结局的比例为58.4%，CBA组为68.2%（对数秩检验：p = 0.571）。
结论
我们的结果表明，接受CBA治疗的HD合并AF患者的结局往往优于接受RFA治疗的患者。因此，CBA可能是HD患者合适的消融方法。
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