评估28mm冷冻球囊应用于左心耳线性消融联合扩大肺静脉前庭消融治疗持续性心房颤动的临床疗效。

An evaluation of the clinical efficacy of the application of 28mm cryoballoon for linear ablation of left atrial apex combined with enlarged pulmonary vein vestibule ablation for persistent atrial fibrillation.

作者信息

Lin Ya-Zhou, Peng Yi-Ming, Lian Lian-Hua, Zhang Jian-Cheng, Wu Mei-Qiong, Yang Zhi-Ping, Chen Jian-Quan, Liao Xue-Wen, Chen Lin

机构信息

Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian 350000, PR China.

出版信息

Hellenic J Cardiol. 2023 Jul-Aug;72:15-23. doi: 10.1016/j.hjc.2023.03.008. Epub 2023 Apr 4.

DOI:10.1016/j.hjc.2023.03.008

PMID:37019212

Abstract

OBJECTIVE

to retrospectively investigate the efficacy and safety of the application of 28 mm cryoballoon for pulmonary vein electrical isolation (PVI) combined with top left atrial linear ablation and pulmonary vein vestibular expansion ablation for persistent atrial fibrillation.

METHODS

From July 2016 to December 2020, 413 patients diagnosed with persistent atrial fibrillation were evaluated, including 230 (55.7%) in the PVI group (PVI only) and 183 (44.3%) in the PVIPLUS group (PVI plus ablation of the left atrial apex and pulmonary vein vestibule). The safety and efficacy of the two groups were retrospectively analyzed.

RESULTS

The AF/AT/AFL-free survival rates at 6, 12, 18, 24 and 30 months after procedure was 86.6%, 72.6%, 70.0%, 61.1% and 56.3% in the PVI group and 94.5%, 87.0%, 84.1%, 75.0% and 67.9% in the PVIPLUS group, respectively. At 30 months after procedure, the AF/AT/AFL-free survival rate was significantly higher in the PVIPLUS group than in the PVI group (P = 0.036; HR:0.63; 95% CI:0.42 to 0.95).

CONCLUSION

The application of 28-mm cryoballoon for pulmonary vein electrical isolation combined with linear ablation of the left atrial apex and expanded ablation of the pulmonary vein vestibule improves the outcome of persistent atrial fibrillation.

摘要

目的

回顾性研究28毫米冷冻球囊用于肺静脉电隔离（PVI）联合左心房顶部线性消融及肺静脉前庭扩展消融治疗持续性房颤的有效性和安全性。

方法

对2016年7月至2020年12月期间诊断为持续性房颤的413例患者进行评估，其中PVI组（仅PVI）230例（55.7%），PVI PLUS组（PVI加左心耳尖部和肺静脉前庭消融）183例（44.3%）。对两组的安全性和有效性进行回顾性分析。

结果

术后6、12、18、24和30个月时，PVI组无房颤/房性心动过速/房扑生存率分别为86.6%、72.6%、70.0%、61.1%和56.3%，PVI PLUS组分别为94.5%、87.0%、84.1%、75.0%和67.9%。术后30个月时，PVI PLUS组无房颤/房性心动过速/房扑生存率显著高于PVI组（P = 0.036；HR：0.63；95%CI：0.42至0.95）。