心房颤动冷冻球囊消融术后复发危险因素的研究进展

Research Progress on Risk Factors for Recurrence of Atrial Fibrillation after Cryoballoon Ablation

心房颤动(AF)是临床常见的心律失常,该病致死、致残率高,可引发血栓栓塞、心力衰竭、脑卒中等并发症,严重威胁患者生命健康。冷冻球囊消融术(CBA)是治疗AF的有效手段,该疗法具有操作时间短、安全性高等优势,国内外指南已将其作为肺静脉隔离的标准疗法。尽管如此,CBA术后复发率高的问题一直困扰着临床医师与患者。影响CBA术后AF复发的因素较多,如使用第一代冷冻球囊、心房重构、血清N端脑钠肽前体水平升高、合并代谢综合征及慢性肾脏病等。近年来随着科学技术的进步,具有新型外形及可变直径球囊的生产获得临床关注,未来期待改善球囊与静脉的接触紧密性,以提高CBA疗效。

Atrial fibrillation(AF),as a kind of arrhythmia with high disability and high mortality,can lead to thromboembolism,stroke and other complications,which seriously threatens the life and health of the patients.Cryoballoon ablation(CBA)is an effective method for the treatment of AF,with the advantages of short surgical time and high safety.CBA has been adopted as the standard therapy for pulmonary vein isolation in domestic and foreign guidelines.Nevertheless,the problem of high recurrence rate after CBA has always plagued the physicians and patients.There are many factors that affect the recurrence of AF after CBA,such as the use of first-generation cryoballoons,atrial remodeling,increased serum N-terminal pro-brain natriuretic peptide,metabolic syndrome and chronic kidney disease,etc.In recent years,with the progress of science and technology,the production of balloon with new shape and variable diameter has gained the clinical attention,which is expected to improve the contact tightness between balloon and vein,so as to improve the efficacy of CBA in the future.