Luo Tao, Chen Yanhong, Xiong Xiong, Cheng Guanghui, Deng Chenggang, Zhang Jinlin
Department of Cardiology, Wuhan Asian Heart Hospital, Wuhan, Hubei, China.
Front Cardiovasc Med. 2023 Dec 7;10:1276317. doi: 10.3389/fcvm.2023.1276317. eCollection 2023.
Increasing age is a significant risk factor for atrial fibrillation (AF) recurrence after catheter ablation (CA). We accomplished this study to evaluate the efficacy and safety of the vein of Marshall (VOM) ethanol infusion (VOM-EI) with CA in elderly patients with persistent AF (PsAF).
This retrospective observational study included 360 consecutive adult patients with PsAF, of which 141 were in the Elder group (age ≥65 years) and 219 were in the Younger group (age <65 years), who underwent the VOM-EI and radiofrequency CA (RFCA) between May 2020 and April 2022. The efficacy endpoint was no recurrence of AF within one year after CA.
The VOM-EI was successfully performed in 90.8% of patients from the Elder and 88.6% from the Younger group. All patients achieved PVI; 97.9% of patients from the Elder and 98.6% from the Younger group reached LA roof block, and 93.6% of patients from the Elder and 95.9% from the Younger group achieved MI block. There was no significant difference in 1-year survival without recurrence of AF between the two groups (83.0% and 84.5%, respectively). The incidence of complications within 30 days after the procedure from the two groups was low and did not differ significantly.
The VOM-EI combined with RFCA proved to be an effective and safe strategy for treating PsAF in elderly and younger patients.
年龄增长是导管消融（CA）术后房颤（AF）复发的重要危险因素。我们开展本研究以评估在持续性房颤（PsAF）老年患者中，马歇尔静脉（VOM）乙醇注入（VOM-EI）联合CA的有效性和安全性。
这项回顾性观察性研究纳入了360例连续性成年PsAF患者，其中141例为老年组（年龄≥65岁），219例为年轻组（年龄<65岁），他们在2020年5月至2022年4月期间接受了VOM-EI和射频消融（RFCA）。有效性终点为CA术后1年内无房颤复发。
老年组90.8%的患者和年轻组88.6%的患者成功进行了VOM-EI。所有患者均实现了肺静脉隔离；老年组97.9%的患者和年轻组98.6%的患者实现了左心房顶部阻滞，老年组93.6%的患者和年轻组95.9%的患者实现了二尖瓣峡部阻滞。两组1年无房颤复发生存率无显著差异（分别为83.0%和84.5%）。两组术后30天内并发症发生率较低且无显著差异。
VOM-EI联合RFCA被证明是治疗老年和年轻患者PsAF的一种有效且安全的策略。
