韩国冷冻球囊注册研究：老年房颤患者冷冻球囊消融的结果
Cryoballoon Ablation for Elderly Patients With Atrial Fibrillation: Results From the Korean Cryoballoon Registry.
作者信息
Kang Dong-Seon, Yang Pil-Sung, Kim Jun-Hyung, Kim Ki-Hun, Kim Ju Youn, Lee So-Ryoung, Park Junbeom, Lee Sung Ho, Kwon Chang Hee, Cha Myung-Jin, Shim Jaemin, Oh Il-Young, Han Sang-Jin, Lim Hong Euy
机构信息
Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.
出版信息
Korean Circ J. 2025 Jul;55(7):614-623. doi: 10.4070/kcj.2024.0308. Epub 2025 Mar 21.
BACKGROUND AND OBJECTIVES
Cryoballoon ablation (CBA) is considered an effective rhythm control treatment for atrial fibrillation (AF) and is increasing exponentially. However, data regarding the efficacy and safety of CBA in elderly patients are limited.
METHODS
A total of 2,652 patients (55.2% with non-paroxysmal AF) from the Korean CBA registry database with follow-up of ≥12-months after de novo CBA were divided into 2 groups based on age (<75 and ≥75 years old). Procedure related complications and clinical outcomes were compared.
RESULTS
Compared to the control group (n=2,403), the elderly group (n=249) had female predominance (41.8% vs. 21.1%, p<0.001), a higher CHA₂DS₂-VASc scores (4.0 [3.0-5.0] vs. 2.0 [1.0-3.0]; p<0.001), and a higher prevalence of heart failure (33.3% vs. 21.9%; p<0.001) and chronic kidney disease (42.2% vs. 10.4%; p<0.001). A total of 120 procedure-related minor complications were reported, but no significant difference was observed between the 2 groups (6.4% vs. 4.3%; p=0.18). Recurrence of atrial tachyarrhythmias was observed in 67 patients (27.2%) in the elderly group and 788 patients (33.3%) in the control group. After adjusting for confounding variables, the freedom from atrial tachyarrhythmias during 24-month was similar between the 2 groups (67.0% vs. 62.7%; adjusted hazard ratio, 0.91; 95% confidence interval, 0.62-1.34; p=0.63).
CONCLUSIONS
CBA showed a reasonable efficacy and safety profile in elderly population with AF, comparable to that in younger patients.
背景与目的
冷冻球囊消融术（CBA）被认为是治疗心房颤动（AF）的一种有效的节律控制方法，并且其应用正在呈指数级增长。然而，关于CBA在老年患者中的疗效和安全性的数据有限。
方法
来自韩国CBA注册数据库的2652例患者（55.2%为非阵发性AF）在初次CBA术后随访≥12个月，根据年龄（<75岁和≥75岁）分为两组。比较手术相关并发症和临床结局。
结果
与对照组（n=2403）相比，老年组（n=249）女性占比更高（41.8%对21.1%，p<0.001），CHA₂DS₂-VASc评分更高（4.0[3.0-5.0]对2.0[1.0-3.0]；p<0.001），心力衰竭患病率更高（33.3%对21.9%；p<0.001）以及慢性肾脏病患病率更高（42.2%对10.4%；p<0.001）。共报告了120例手术相关的轻微并发症，但两组之间未观察到显著差异（6.4%对4.3%；p=0.18）。老年组有67例患者（27.2%）出现房性快速性心律失常复发，对照组有788例患者（33.3%）出现复发。在调整混杂变量后，两组在24个月内心房快速性心律失常的无事件生存率相似（67.0%对62.7%；调整后的风险比，0.91；95%置信区间，0.62-1.34；p=0.63）。
结论
CBA在老年AF患者中显示出合理的疗效和安全性，与年轻患者相当。
Zotero 插件