Bocz Botond, Debreceni Dorottya, Jánosi Kristof-Ferenc, Torma Dalma, Kupo Peter
Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary.
J Clin Med. 2025 Mar 20;14(6):2119. doi: 10.3390/jcm14062119.
: Atrial fibrillation is the most common sustained arrhythmia worldwide. Pulmonary vein isolation (PVI) is the most effective catheter ablation technique for treating paroxysmal atrial fibrillation (pAF). Common ablation methods include point-by-point radiofrequency (RF) ablation and single-shot techniques such as cryoballoon ablation (CB). This single-center, prospective study aimed to compare the efficacy of ablation index-guided RF ablation (AI-RF) and CB in patients with symptomatic, antiarrhythmic-resistant pAF. : A total of 154 patients undergoing initial PVI were divided into two groups (CB: 51, AI-RF: 103), based on the operators' decision. Procedural data (total procedure time, fluoroscopy time, radiation dose, complication rate) and recurrence rates were analyzed over a 12-month follow-up period. : The CB group had a significantly shorter total procedure time compared to the AI-RF group (64 [57; 74.8] minutes vs. 92 [76; 119] minutes; < 0.001). However, the CB group experienced higher fluoroscopy times (559 [395; 868] seconds vs. 167 [126; 224] seconds; < 0.001) and a greater fluoroscopy dose (21.8 [11.7; 40.1] mGy vs. 7.65 [5.21; 14.5] mGy; < 0.001). Recurrence rates were similar during both the blanking period (11.7% vs. 10.7%; = 0.84) and the 12-month follow-up period (22.7% vs. 13.4%; = 0.22). No major complications were reported during this study. : In this single-center study, there were no significant differences in long-term recurrence or complication rates between the CB and AI-RF groups for patients with antiarrhythmic-refractory, symptomatic pAF. While the CB group benefited from a significantly shorter procedure time, it required a higher fluoroscopy dose and a longer fluoroscopy time.
心房颤动是全球最常见的持续性心律失常。肺静脉隔离（PVI）是治疗阵发性心房颤动（pAF）最有效的导管消融技术。常见的消融方法包括逐点射频（RF）消融和单次技术，如冷冻球囊消融（CB）。这项单中心前瞻性研究旨在比较消融指数引导的RF消融（AI-RF）和CB对有症状、抗心律失常治疗无效的pAF患者的疗效。
共有154例接受初次PVI的患者根据术者的决定分为两组（CB组：51例，AI-RF组：103例）。在12个月的随访期内分析手术数据（总手术时间、透视时间、辐射剂量、并发症发生率）和复发率。
与AI-RF组相比，CB组的总手术时间显著缩短（64 [57；74.8]分钟对92 [76；119]分钟；<0.001）。然而，CB组的透视时间更长（559 [395；868]秒对167 [126；224]秒；<0.001），透视剂量更大（21.8 [11.7；40.1] mGy对7.65 [5.21；14.5] mGy；<0.0者均未报告严重并发症。
在这项单中心研究中，对于抗心律失常治疗无效、有症状的pAF患者，CB组和AI-RF组在长期复发率或并发症发生率方面无显著差异。虽然CB组的手术时间明显缩短，但其需要更高的透视剂量和更长的透视时间。 01）。在空白期（11.7%对10.7%；=0.84）和12个月随访期（22.7%对13.4%；=0.22），两组的复发率相似。本研究期间两
