一代冷冻球囊消融治疗心房颤动的单中心一年随访结果  

Efficacy of 1st generation cryoballon therapy in atrial fibrillation, an single center, 1 year follow-up study

作　　者：林亚洲[1] 陈林[1] 连亮华[1] 陈建泉[1] 吴梅琼[1] 杨志平[1] 张建成[1] 翁川晴[1] 廖学文[1] 

机构地区：[1]福建医科大学省立临床学院福建省立医院心内科,福州350001

出　　处：《中华心律失常学杂志》2017年第1期58-62,共5页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的 观察一代冷冻球囊消融（CBA）治疗心房颤动（房颤）的单中心1年随访结果,探讨CBA的中期有效性.方法 连续入选2014年5月至2015年3月在福建省立医院接受CBA治疗房颤患者159例,分析3、6、12个月及1年后成功率,研究分为阵发性房颤组和持续性房颤组、23 mm球囊组和28 mm球囊组,根据学习曲线1～50例与51～159例阶段不同组别进行统计比较各组单次手术成功率.结果 单次CBA术后平均随访12～22（16.9±2.9）个月,43例空白期外复发房性心律失常,其中20例接受2次射频消融手术.单次CBA手术成功率在3、6、12个月及1年后随访期可达91.2％（145/159）、87.4％（139/159）、78.5％（117/149）及72.7％（101/139）;联合2次手术后1年及1年后随访期,其成功率进一步提高到83.9％（126/149）和81.1％（129/159）.比较阵发性房颤（n=115）与持续性房颤（n=44）,不同随访时间点单次成功率为（91.3％对90.9％,P=0.81）、（88.7％对84.1％,P=0.43）、（82.6％对70.0％,P=0.09）和（77.7％对61.1％,P=0.048）.分析28 mm球囊（n=112）和23 mm球囊（n=47）,不同随访时间点单次CBA成功率为（93.8％对85.1％,P=0.052）、（91.1％对78.7％,P=0.03）、（84.9％对65.1％,P=0.006）和（80.0％对59.0％,P=0.01）,学习曲线时间截点分析中前1～50例和后51～159例 3、6个月和1年随访期成功率分别为（80.0％对96.3％,P=0.002）、（72.0％对94.5％,P=0.007）和（66.7％对86.5％,P=0.005）.结论 应用一代冷冻球囊治疗房颤尤其是阵发性房颤具有良好的中期成功率,28 mm球囊与丰富的手术经验可以进一步提高成功率.Objective The purpose of this study was to evaluate the efficacy of first generation cryoballon ablation therapy in atrial fibrillation.MethodsOne hundred fifty-nine patients were enrolled in succession,received CBA therapy due to atrial fibrillation from May 2014 to March 2015.Patients were divided into PAF and PeAF groups based on the arrhythmia history;and 28 mm groups and 23 mm ballon groups due to cryoballon diameter;initial 50（1-50 th）and subsequent 101（51-159 th）groups in learning curve.The success rates in 3months,6months,12months and beyond 12months were analyzed during follow-ups.Results During 12～22（16.9±2.9）months follow-up,43 cases recurred（atrial fibrillation and atrial tachycardias）after first 3 months blank periods,and 20 patients received repeat RFCA procedures.the success rate of single CBA therapy was 91.2%（145/159）,87.4%（139/159）,78.5%（117/149）and 72.7%（101/139）in 3 month,6 months,12 months and after 12 months follow-ups;the CBA success rate was difference between 28 mm（n=112）and 23 mm（n=47）ballon group 93.8%vs.85.1%（P=0.052）,91.1%vs.78.7%（P=0.03）,84.9%vs.65.1%（P=0.006）,and 80.0%vs.59.0%（P=0.01）respectively.In the learning curve phase analysis,the initial 50（1-50 th）and subsequent 101（51-159 th）groups,the success rate was 80.0%vs.96.3%（P=0.002）,72.0%vs.94.5%（P=0.007）and 66.7%vs.86.5%（P=0.005）respectively in the follow-ups.Conclusion The first generation balloon CBA therapy may be effective,with high middle-term success rates,especially in paraoxymal atrial fibrillation groups,28 mm balloon group and experience could improve the efficacy.

关 键 词：心房颤动 冷冻球囊消融 随访 

分 类 号：R541.75[医药卫生—心血管疾病]