内科理论与实践2018，Vol.13Issue(1)：24-29,6.DOI:10.16138/j.1673-6087.2018.01.006
冷冻球囊消融治疗阵发性心房颤动的长期临床结果
Long-term clinical outcome of cryoballon ablation in treatment of paroxysmal atrial fibrillation
摘要
Abstract
Objective To evaluate the safety and effectiveness of cryoballon ablation (CBA) for the treatment of paroxysmal atrial fibrillation (PAF) and to investigate the predictive factors that may be related to the recurrence of AF. Methods A retrospective analysis of 146 consecutive PAF patients who underwent CBA in our hospital from December 2013 to June 2015 were enrolled. The first-generation 28 mm cryoballon was the first choice, and if repeated ablation did not achieve pulmonary vein isolation (PVI), then 23 mm cryoballon was chosen. The effectiveness was analyzed. The primary endpoint was the occurrence of AF after the blanking period (90 d after the CBA). And the predictors of late recurrence (more than3 months) of AF were analyzed. Results The success rate of PVI was 97.3％, mean procedure time was (99.7±23.8) minutes. After a mean follow-up of(30.3±6.1) months, the success rate of CBA was 63.0％ (92/146). No severe complications such as pericardial tamponade, left atrium-esophagus fistula and symptomatic pulmonary vein stenosis were found in this study. Ischemic stroke happened in 1 patient. One patient had arterio-venous fistula. Temporary phrenic nerve palsy(PNP) was observed in 3 patients. Multivariate Logistic regression analysis showed that left atrium volume [odds ratio (OR):1.014, 95％ confidence interval (CI): 1.001-1.028, P=0.039] and serum uric acid level (OR: 1.009, 95％ CI: 1.001-1.016, P=0.025) before CBA were the risk factors for late AF recurrence. Conclusions CBA has good safety and long-term effectiveness for the treatment of patients with paroxysmal atrial fibrillation. Left atrial volume and serum uric acid level before the procedure are the independent risk factors for late recurrence of AF after CBA.关键词
阵发性心房颤动/冷冻球囊/导管消融/复发Key words
Paroxysmal atrial fibrillation/Cryoballoon ablation/Catheter ablation/Recurrence of atrial fibrillation分类
医药卫生引用本文复制引用
吉懿,于姝姝,林长坚,潘文麒,金奇,吴立群,凌天佑,张凝,卫越,刘傲,罗庆志,叶佳雯,刑超凡,邱筱炜..冷冻球囊消融治疗阵发性心房颤动的长期临床结果[J].内科理论与实践,2018,13(1):24-29,6.基金项目
上海市科学技术委员会科研计划项目(项目编号:14411961100) （项目编号:14411961100）
国家自然科学基金项目(项目编号:81600270) （项目编号:81600270）
上海交通大学医学院多中心临床研究项目(项目编号:DLY201604) （项目编号:DLY201604）
上海交通大学医学院高峰高原学科建设项目 （）
