压力感知导管和二代冷冻球囊消融治疗持续性心房颤动效果的回顾性研究

Retrospective study of the effects of contact force-guided radiofrequency ablation and secondgeneration cryoballoon ablation for persistent atrial fibrillation

目的比较压力感知导管和二代冷冻球囊消融治疗持续性心房颤动(房颤)的效果和安全性。方法回顾性连续入选2016年12月至2018年12月在南京大学医学院附属鼓楼医院首次行压力感知导管或二代冷冻球囊消融的持续性房颤患者201例,根据患者使用的手术方式不同分为压力感知导管组(146例)和二代冷冻球囊组(55例)。观察两组患者术中X线曝光时间、手术操作时间、手术相关并发症及术后1年房颤/心房扑动(房扑)/房性心动过速(房速)复发情况。结果两组患者各项基线资料指标比较,差异均无统计学意义(均P>0.05);二代冷冻球囊组手术操作时间短于压力感知导管组[(127.9±35.1)min比(158.3±48.5)min,P<0.001],而X线暴露时间长于压力感知导管组[(27.8±11.5)min比(12.1±6.3)min,P<0.001],差异均有统计学意义;两组患者各种手术并发症发生率比较,差异均无统计学意义(均P>0.05);压力感知导管组和二代冷冻球囊组患者术后1年房颤/房扑/房速的复发率分别为24.0%和25.5%,Log-rank检验比较两组患者无房颤/房扑/房速生存率差异无统计学意义(P=0.811)。结论使用压力感知导管或二代冷冻球囊消融治疗持续性房颤,疗效及安全性相当。

Objective To compare the effi cacy and safety of pulmonary vein isolation(PVI)for persistent atrial fibrillation(PAF)using contact force(CF)-guided radiofrequency(RF)or second-generation cryoballoon(CB).Methods A total of 201 patients with persistent atrial fi brillation that received standardized PVI catheter ablation using CF-guided RF ablation(Thermocoolw Smart Touch TM,Biosense Webster)(CF group,146 cases)or second-generation CB ablation(Arctic Front AdvanceTM,Medtronic)(CB group,55 cases)for the first time were enrolled retrospectively in our hospital between December 2016 to December 2018.The X-ray exposure time,operation time,operation related complications and recurrence of atrial fi brillation/atrial fl utter/atrial tachycardia 1 year after operation of the two groups were analyzed.Results There were no signifi cant diff erences in baseline data between the two groups(P>0.05).The operation time of CB group was signifi cantly shorter than that of the CF group[(127.9±35.1)min vs.(158.3±48.5)min,P<0.001],but X-ray exposure time was longer[(27.8±11.5)min vs.(12.1±6.3)min,P<0.001].There was no peri-procedural death.Complication rates were similar in both groups(P>0.05).The one-year recurrence rate of atrial fi brillation/atrial fl utter/atrial tachycardia in CF group and CB group was 24.0%and 25.5%respectively,there was no signifi cant diff erence in atrial fi brillation/atrial fl utter/atrial tachycardia free survival rate between the two groups by Log-rank test(P=0.811).Conclusions Effi cacy and safety of pulmonary vein isolation using CF-guided RF and second-generation CB in the treatment of persistent atrial fi brillation were similar.