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亚洲队列中冷冻球囊消融治疗心房颤动的疗效及复发预测因素

Efficacy of Cryoballoon Ablation for Atrial Fibrillation and Recurrence Predictors in an Asian Cohort.

作者信息

Wu Shang-Ju, Li Cheng-Hung, Weng Chi-Jen, Lin Jiunn-Cherng, Chien Yu-Shan, Chen Yi-Huei, Lin Ching-Heng, Hsieh Yu-Cheng, Huang Jin-Long, Lo Li-Wei, Lin Yenn-Jiang, Chen Shih-Ann

机构信息

Cardiovascular Center, Taichung Veterans General Hospital, Taichung 40705, Taiwan.

Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 11217, Taiwan.

出版信息

J Pers Med. 2022 Apr 30;12(5):732. doi: 10.3390/jpm12050732.

Abstract

BACKGROUND

Cryoballoon ablation (CBA) for atrial fibrillation (AF) is a rhythm control procedure used in clinical trials, mostly in Western countries. Its efficacy and the predictors of AF recurrence after CBA remain unclear for Asian populations. We aimed to investigate the efficacy of CBA and the predictors of AF recurrence after CBA in Asian AF patients.

METHODS

We included consecutive AF patients undergoing CBA for rhythm control between 2014 and 2020. The baseline characteristics, including AF types, symptom severity, and left atrial diameter (LAD), were analyzed. Holter's monitoring and 12-lead ECG were performed to document AF recurrence. A multivariate Cox hazards regression model was used to evaluate the risk of AF recurrence.

RESULTS

A total of 120 AF patients (aged 61.9 ± 9.3 years) were included. The percentage of patients free from AF in the year following CBA was 74.2%. Among the three independent predictors of AF recurrence within one year were the presence of persistent AF ( 0.025), an LAD ≥ 4.75 cm ( = 0.016), and pre-procedural cardioversion ( = 0.025). All patients survived and none had a stroke after CBA.

CONCLUSION

CBA for AF is an effective and safe procedure in Asian populations. The presence of persistent AF, an LAD ≥ 4.75 cm, and severe symptoms are predictors of AF recurrence in the year following CBA.

摘要

背景

冷冻球囊消融术(CBA)治疗心房颤动(AF)是一种用于临床试验的节律控制方法,主要在西方国家使用。对于亚洲人群,CBA术后AF复发的疗效及预测因素仍不明确。我们旨在研究CBA治疗亚洲AF患者的疗效及CBA术后AF复发的预测因素。

方法

我们纳入了2014年至2020年间连续接受CBA进行节律控制的AF患者。分析了包括AF类型、症状严重程度和左心房直径(LAD)在内的基线特征。进行动态心电图监测和12导联心电图检查以记录AF复发情况。使用多变量Cox风险回归模型评估AF复发风险。

结果

共纳入120例AF患者(年龄61.9±9.3岁)。CBA术后一年无AF患者的比例为74.2%。一年内AF复发的三个独立预测因素为持续性AF的存在(P=0.025)、LAD≥4.75 cm(P=0.016)和术前复律(P=0.025)。所有患者均存活,CBA术后无一例发生卒中。

结论

CBA治疗AF在亚洲人群中是一种有效且安全的方法。持续性AF的存在、LAD≥4.75 cm和严重症状是CBA术后一年AF复发的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/352b/9144244/0eddd4d8c3f6/jpm-12-00732-g001.jpg

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