Department of Cardiology, Ankara City Hospital, Ankara, Turkey.
Department of Cardiology, Eskişehir Osmangazi University School of Medicine, 26040, Odunpazari, Eskisehir, Turkey.
J Interv Card Electrophysiol. 2022 Sep;64(3):597-605. doi: 10.1007/s10840-021-01084-x. Epub 2021 Oct 28.
Cryoballoon (CB) and radiofrequency (RF) ablation techniques have similar outcomes for pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). However, there is limited data about the impact of different ablation strategies in patients with left common pulmonary vein (LCPV). Our aim was to compare the safety and efficacy of RF and CB ablation in AF patients with LCPV.
One hundred and twenty-seven (n = 80 CB and n = 47 RF) AF patients with LCPV detected by preprocedural computerized tomography (CT) were included in the study. Ostial dimensions and trunk distance were measured in all patients. Atrial tachyarrhythmia (ATa) recurrence was defined as detection of AF, atrial flutter, or atrial tachycardia (≥ 30 s) after a 3-month blanking period.
There was no significant difference in acute procedural success rates for PVI (97.5% in CB and 97.9% in RF, respectively, P = 0.953) and complication rates were similar between the groups (6 (7.5%) in CB and 4 (8.5%) in RF, respectively, P = 1.000). During a median follow-up of 20.7 (4.8-50.2) months for CB and 20.5 (6.2-36.0) months for RF, ATa recurrence was 35.0% and 38.2%, respectively (P = 0.777). Multivariate analysis did not reveal any of the morphologic parameters of LCPV as a significant predictor of ATa recurrence.
Our findings demonstrated that both CB and RF ablation techniques have similar efficacy and safety in AF patients with LCPV during the mid-term follow-up.
在患有心房颤动（AF）的患者中，冷冻球囊（CB）和射频（RF）消融技术在肺静脉隔离（PVI）方面具有相似的结果。然而，关于不同消融策略在左总肺静脉（LCPV）患者中的影响的数据有限。我们的目的是比较 RF 和 CB 消融在 LCPV 患者中的安全性和疗效。
本研究共纳入 127 例（n=80 例 CB 和 n=47 例 RF）经术前计算机断层扫描（CT）检测到 LCPV 的 AF 患者。所有患者均测量了口部尺寸和干距离。房性心动过速（ATa）复发定义为在 3 个月空白期后检测到 AF、心房扑动或房性心动过速（≥30 s）。
PVI 的即刻手术成功率无显著差异（分别为 CB 组 97.5%和 RF 组 97.9%，P=0.953），两组的并发症发生率也相似（分别为 CB 组 6 例（7.5%）和 RF 组 4 例（8.5%），P=1.000）。CB 组中位随访 20.7（4.8-50.2）个月，RF 组中位随访 20.5（6.2-36.0）个月，ATa 复发分别为 35.0%和 38.2%（P=0.777）。多变量分析未发现 LCPV 的任何形态参数可作为 ATa 复发的显著预测因素。
在中期随访中，我们的研究结果表明，在 LCPV 患者中，CB 和 RF 消融技术在 AF 治疗中具有相似的疗效和安全性。
