Lim Hong Euy, Oh Il-Young, Kueffer Fred J, van Bragt Kelly Anna, On Young Keun
Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
Korean Circ J. 2022 Oct;52(10):755-767. doi: 10.4070/kcj.2022.0127. Epub 2022 Aug 12.
Cryoballoon catheter ablation for the treatment of patients with symptomatic atrial fibrillation (AF) has been adopted globally, but there are limited multicenter reports of 12-month outcomes in the Korean patient population. This analysis evaluated the clinical performance and safety of cryoballoon ablation (CBA) according to standard-of-care practices in Korea.
This evaluation of Korean patients with AF was conducted within the larger Cryo Global Registry, which is a prospective, multicenter, post-market registry. Freedom from a ≥30-second recurrence of atrial arrhythmias (after a 90-day blanking period until 12 months) and procedural safety were examined in subjects treated with CBA at 3 Korean centers.
Overall, 299 patients with AF (60±11 years old, 24.7% female, 50.5% paroxysmal AF) underwent CBA using the Arctic Front Advance cryoballoon. Of those, 298 were followed-up for at least 12 months. Mean procedure-, left atrial dwell- and fluoroscopy time was 76±21 minutes, 56±23 minutes, and 27±23 minutes, respectively. Freedom from AF recurrence at 12 months was 83.9% (95% confidence interval [CI], 76.9-88.9%) in the paroxysmal and 61.6% (95% CI, 53.1-69.0%) in the persistent AF cohort. Rhythm monitoring was performed on average 4.7±1.4 times during the follow-up period. Serious device- or procedure-related adverse events occurred in 2 patients (0.7%). The 12-month Kaplan-Meier estimate of freedom from repeat ablation and cardiovascular-related hospitalization was 93.8% (95% CI, 90.4-96.1%) and 89.7% (95% CI, 85.6-92.7%), respectively.
CBA is an efficient, effective, and safe procedure for the treatment of AF patients when used according to real-world practices in Korea.
ClinicalTrials.gov Identifier: NCT02752737.
冷冻球囊导管消融术用于治疗有症状心房颤动(AF)患者已在全球范围内得到应用,但关于韩国患者人群12个月结局的多中心报告有限。本分析根据韩国的标准治疗方法评估了冷冻球囊消融术(CBA)的临床疗效和安全性。
对韩国AF患者的评估在更大规模的全球冷冻注册研究中进行,这是一项前瞻性、多中心、上市后注册研究。在韩国3个中心接受CBA治疗的受试者中,检查了心房心律失常复发≥30秒的自由度(在90天空白期后至12个月)以及手术安全性。
总体而言,299例AF患者(60±11岁,女性占24.7%,阵发性AF占50.5%)使用Arctic Front Advance冷冻球囊进行了CBA。其中,298例患者接受了至少12个月的随访。平均手术时间、左心房停留时间和透视时间分别为76±21分钟、56±23分钟和27±23分钟。阵发性AF队列12个月时无AF复发的比例为83.9%(95%置信区间[CI],76.9 - 88.9%),持续性AF队列中为61.6%(95%CI,53.1 - 69.0%)。随访期间平均进行了4.7±1.4次心律监测。2例患者(0.7%)发生了严重的与器械或手术相关的不良事件。12个月时,无重复消融和心血管相关住院的Kaplan - Meier估计值分别为93.8%(95%CI,90.4 - 96.1%)和89.7%(95%CI,85.6 - 92.7%)。
按照韩国的实际应用情况,CBA是治疗AF患者的一种高效、有效且安全的手术方法。
ClinicalTrials.gov标识符:NCT02752737。