高功率与传统功率射频消融治疗心房颤动的有效性和安全性比较。
Comparison of effectiveness and safety of high-power vs. conventional-power radiofrequency ablation for treatment of atrial fibrillation.
作者信息
Cui Penghui, Qu Yunpeng, Zhang Jichang, Wu Junduo, Zhang Jing, Shi Yongfeng, Liu Bin
机构信息
Department of Cardiology, The Second Hospital of Jilin University, Changchun, China.
Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
Front Cardiovasc Med. 2022 Dec 6;9:988602. doi: 10.3389/fcvm.2022.988602. eCollection 2022.
AIM
To compare high-power (HP) vs. conventional-power (CP) radiofrequency ablation for atrial fibrillation (AF).
METHODS
We retrospectively enrolled AF patients undergoing CP (30-40 W, 43 patients) or HP (50 W, 49 patients) radiofrequency ablation. Immediate pulmonary vein (PV) single-circle isolation, PV-ablation time, AF recurrence, AF recurrence-free survival, and complications were analyzed.
RESULTS
Diabetes was more common in the CP group than in the HP group (27.91% vs. 10.20%, = 0.029). The left PV single-circle isolation rate (62.79% vs. 65.31%), right PV single-circle isolation rate (48.84% vs. 53.06%), and bilateral PV single-circle isolation rate (32.56% vs. 38.78%; all > 0.05) did not differ between the groups. Single-circle ablation times for the left PVs (12.79 ± 3.39 vs. 22.94 ± 6.39 min), right PVs (12.18 ± 3.46 vs. 20.67 ± 5.44 min), and all PVs (25.85 ± 6.04 vs. 45.66 ± 11.11 min; all < 0.001) were shorter in the HP group. Atrial fibrillation recurrence within 3 months (13.95% vs. 18.37%), at 3 months (11.63% vs. 8.16%), and at 6 months after ablation (18.60% vs. 12.24%; all > 0.05) was similar in both groups. Atrial fibrillation recurrence-free survival did not differ between the groups (Kaplan-Meier analysis). Cardiac rupture and pericardial tamponade did not occur in any patient. Pops occurred in 2 and 0 patients in the HP and CP groups, respectively (4.08% vs. 0.00%, = 0.533).
CONCLUSION
High-power ablation improved operation time and efficiency without increasing complications.
目的
比较高功率（HP）与传统功率（CP）射频消融治疗心房颤动（AF）的效果。
方法
我们回顾性纳入了接受CP（30 - 40瓦，43例患者）或HP（50瓦，49例患者）射频消融的AF患者。分析即刻肺静脉（PV）单环隔离、PV消融时间、AF复发、无AF复发生存率及并发症情况。
结果
CP组糖尿病患者比HP组更常见（27.91%对10.20%，P = 0.029）。两组间左PV单环隔离率（62.79%对65.31%）、右PV单环隔离率（48.84%对53.06%）及双侧PV单环隔离率（32.56%对38.78%；均P > 0.05）无差异。HP组左PVs单环消融时间（12.79 ± 3.39对22.94 ± 6.39分钟）、右PVs单环消融时间（12.18 ± 3.46对20.67 ± 5.44分钟）及所有PVs单环消融时间（25.85 ± 6.04对45.66 ± 11.11分钟；均P < 0.001）更短。两组在消融后3个月内（13.95%对18.37%）、3个月时（11.63%对8.16%）及6个月时（18.60%对12.24%；均P > 0.05）的AF复发情况相似。两组间无AF复发生存率无差异（Kaplan - Meier分析）。所有患者均未发生心脏破裂和心包填塞。HP组和CP组分别有2例和0例患者发生爆裂声（4.08%对0.00%，P = 0.533）。
结论
高功率消融可改善手术时间和效率，且不增加并发症。
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