基于基质标测加肺静脉隔离的扩大 antrum 消融术治疗心房颤动的疗效。 （注：antrum 可能是特定医学术语中一个不太常见或有特定含义的词汇，文中未对其进行进一步解释，可根据具体医学背景进一步理解其准确含义）
Efficacy of extended antrum ablation based on substrate mapping plus pulmonary vein isolation in the treatment of atrial fibrillation.
作者信息
Chen Lin, Chen Jian-Quan, Zou Tian, Chen Qian, Lian Liang-Hua, Yang Zhi-Ping, Wu Mei-Qiong, Lin Ya-Zhou, Peng Yi-Ming, Lin Wei, Liao Xue-Wen, Huang Qi-Lei, Zhang Jian-Cheng
机构信息
Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, PR China.
Department of Critical Care Medicine Division Four, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, PR China.
出版信息
Rev Port Cardiol. 2022 Jan;41(1):17-26. doi: 10.1016/j.repc.2021.02.014. Epub 2021 Sep 22.
INTRODUCTION AND OBJECTIVES
Pulmonary vein isolation (PVI) technique has become the cornerstone of atrial fibrillation (AF) catheter ablation. The objective of this study was to assess the efficacy and safety of extended antrum ablation based on electrophysiological substrate mapping plus PVI in AF patients who underwent cryoballoon ablation.
METHODS
In this observational study, a total of 121 paroxysmal AF patients and 80 persistent AF patients who did not achieve the procedure endpoint after cryoballoon ablation received extra extended antrum ablation (EAA) based on electrophysiological substrate mapping via radiofrequency ablation (EAA group). As a control group (PVI group), among paroxysmal AF and persistent AF patients, we conducted a propensity score-matched cohort, in whom only PVI was completed.
RESULTS
The average follow-up time was 15.27±7.34 months. Compared with PVI group, paroxysmal AF patients in the EAA group had a significantly higher rate of AF-free survival (90.1% vs. 80.2%, p=0.027) and AF, atrial flutter, or atrial tachycardia (AFLAT) -free rate survival (89.3% vs. 79.3%, p=0.031). Persistent AF patients in the EAA group also had a significantly higher rate of AF-free survival (90.0% vs. 75.0%, p=0.016) and AFLAT-free survival (88.8% vs. 75.0%, p=0.029) than PVI group. Complication rates did not significantly differ between both groups, in either paroxysmal AF or persistent AF patients.
CONCLUSION
Our findings demonstrate that extra extended antrum ablation based on electrophysiological substrate mapping is effective and safe. Moreover, the strategy can improve the outcome of AF cryoablation.
引言与目的
肺静脉隔离（PVI）技术已成为心房颤动（AF）导管消融的基石。本研究的目的是评估在接受冷冻球囊消融的AF患者中，基于电生理基质标测加PVI的扩展前庭消融的有效性和安全性。
方法
在这项观察性研究中，共有121例阵发性AF患者和80例持续性AF患者在冷冻球囊消融后未达到手术终点，接受了基于电生理基质标测的额外扩展前庭消融（EAA）（EAA组）。作为对照组（PVI组），在阵发性AF和持续性AF患者中，我们进行了倾向评分匹配队列，其中仅完成了PVI。
结果
平均随访时间为15.27±7.34个月。与PVI组相比，EAA组阵发性AF患者的无AF生存率（90.1%对80.2%，p=0.027）和无AF、心房扑动或房性心动过速（AFLAT）生存率（89.3%对79.3%，p=0.031）显著更高。EAA组持续性AF患者的无AF生存率（90.0%对75.0%，p=0.016）和无AFLAT生存率（88.8%对75.0%，p=0.029）也显著高于PVI组。两组间并发症发生率在阵发性AF或持续性AF患者中均无显著差异。
结论
我们的研究结果表明，基于电生理基质标测的额外扩展前庭消融是有效且安全的。此外，该策略可改善AF冷冻消融的效果。
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