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复发性持续性心房颤动的重复手术:射频左心房线性消融与冷冻球囊后壁隔离之间的倾向匹配评分比较

Repeat procedures for recurrent persistent atrial fibrillation: A propensity-matched score comparison between left atrial linear ablation with radiofrequency and posterior wall isolation with the cryoballoon.

作者信息

Bisignani Antonio, Pannone Luigi, Bala Gezim, Kazawa Shuichiro, Calburean Paul, Overeinder Ingrid, Monaco Cinzia, Lipartiti Felicia, Miraglia Vincenzo, Rizzi Sergio, Al Housari Maysam, Mojica Joerelle, Strazdas Antanas, Osório Thiago Guimarães, Sieira Juan, Iacopino Saverio, Almorad Alexandre, Ströker Erwin, Sorgente Antonio, Brugada Pedro, de Asmundis Carlo, Chierchia Gian-Battista

机构信息

Heart Rhythm Management Centre Universitair Ziekenhuis Brussel Postgraduate Program in Cardiac Electrophysiology and Pacing European Reference Networks Guard-Heart Vrije Universiteit Brussel Brussels Belgium.

Institute of Cardiology Catholic University of the Sacred Heart Rome Italy.

出版信息

J Arrhythm. 2021 Aug 10;37(5):1287-1294. doi: 10.1002/joa3.12614. eCollection 2021 Oct.

Abstract

AIMS

To evaluate the clinical outcome in patients undergoing repeat procedures for recurrent persistent atrial fibrillation following an index cryoballoon (CB-A) pulmonary vein isolation ablation on a mid-term follow-up of 12 months.

METHODS

In this propensity score-matched comparison, 50 patients undergoing left atrial posterior wall isolation (LAPWI) with the CB-A were matched to 50 patients treated with additional linear ablation using radiofrequency catheter ablation (RFCA).

RESULTS

Meantime to repeat the procedure was 9.74 ± 4.36 months. At 12 months follow-up freedom from atrial tachyarrhythmias (ATas) was achieved in 82% of patients in the LAPWI group and in 62% of patients in the linear ablation group ( = .03). Regression analysis demonstrated that relapses during the blanking period and LA dimensions were independent predictors of ATas recurrences following the repeat procedure.

CONCLUSION

LAPWI using CB-A is associated with a significantly higher freedom from atrial arrhythmias when compared with the RFCA mediated left atrial linear lesions on a mid-term follow-up of 12 months in patients with persAF undergoing a redo procedure.

摘要

目的

评估在接受初次冷冻球囊(CB-A)肺静脉隔离消融术后12个月中期随访时,复发性持续性房颤患者接受再次手术的临床结局。

方法

在这项倾向评分匹配比较中,50例行CB-A左房后壁隔离(LAPWI)的患者与50例行额外射频导管消融(RFCA)线性消融治疗的患者进行匹配。

结果

再次手术的平均时间为9.74±4.36个月。在12个月随访时,LAPWI组82%的患者和线性消融组62%的患者实现了无房性快速心律失常(ATas)(P=0.03)。回归分析表明,空白期复发和左房大小是再次手术后ATas复发的独立预测因素。

结论

在接受再次手术的持续性房颤患者中,在12个月中期随访时,与RFCA介导的左房线性损伤相比,使用CB-A的LAPWI与显著更高的无房性心律失常发生率相关。

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