消融指数指导下阵发性心房颤动射频消融安全和有效性研究

Study on safety and efficacy of radiofrequency ablation of paroxysmal atrial fibrillation guided by ablation index

目的:探讨消融指数(AI)指导下射频消融治疗阵发性心房颤动的安全性和有效性。方法:回顾性纳入了2016年12月至2018年1月,于安贞医院阵发性心房颤动患者行压力(CF)指导下环肺静脉隔离(PVI)58例和AI指导下PVI 58例患者;观察两组患者术中单圈PVI隔离率、术中肺静脉电传导恢复情况及随访12个月心房颤动复发率。结果:AI组单圈消融PVI隔离率显著高于CF组(82.8%vs.69.0%,P=0.014),20 min观察期中AI组肺静脉电传导恢复率明显低于CF组(8.6%vs.18.1%P=0.034),AI组术后12个月内心房颤动复发率明显低于CF组(15.5%vs.31.0%, Log rank P=0.045)。两组患者均未发生心包填塞、围手术期死亡等并发症。结论:AI指导下射频量化消融治疗阵发性心房颤动手术安全有效。

Objective: To investigate safety and clinical efficacy radiofrequency ablation for paroxysmal atrial fibrillation(PAF) under the guidance of ablation index(AI). Methods: Procedural and 12-month outcomes of ablation for pAF were retrospectively compared between consecutive patients undergoing either AI-guided pulmonary vein isolation(PVI)(n=58) or contact force(CF) guided PVI at a single center. Results: First-pass PVI was more frequent in AI-group than in CF-group(82.8% vs. 69.0%, P=0.014), and acute PV reconnection was lower(8.6% vs. 18.1%, P=0.034). None major complications occurred in CF-group and in AI-group. Atrial tachyarrhythmia recurrence was significantly lower in AI-group than in CF-group(15.5% vs. 31.0%, Log rank P=0.045). Conclusions: Radiofrequency ablation guided by AI is safe and effective in the treatment of PAF.