摘要
Objective:This study is aimed to analyze the long-term safety and effectiveness of second-generation cryoballoon(CB2)ablation in the treatment of atrial fibrillation(AF).Methods:Data from 760 consecutive patients in the Department of Cardiology,General Hospital of Northern Theater Command from August 2016 to December 2018 with drug-refractory symptomatic AF undergoing pulmonary vein isolation(PVI)using CB2 were assessed.Procedure-related safety and freedom from AF and atrial flutter/atria tachycardia through 3 years were determined.The risk factors related to atrial tachyarrhythmia recurrence were analyzed.Results:Acute PVI was achieved in 100%of the 760 patients.Radiofrequency application for additional focal ablation was needed in 11(1.4%)patients and for 14 pulmonary veins(0.5%,14/(760×4))to achieve PVI.A total of 748 patients,including 539 with paroxysmal AF(PAF)and 209 with persistent AF(SAF)completed the follow-up,and only 12(1.6%)patients were lost.The mean follow-up duration was(19±8)months.The rate of major complications was 0.9%,including 0.8%of right phrenic nerve injury,which resolved before discharge.Freedom from all tachyarrhythmias was achieved in 75.0%,69.4%,and 63.2%of patients with PAF,respectively,at 12-,24-,and 36-month follow-up,and in 75.1%,67.4%,and 60.9%for SAF,with no significant differences between the PAF and SAF groups.AF course and the rate of body weight gain were independent risk factors for recurrence at 12 months after ablation(P=0.001 and P=0.009,respectively).Conclusion:PVI using CB2 has a high acute success rate and good safety in the treatment of PAF and SAF.Long course of AF and weight gain after ablation were independent risk factors for recurrence.
