冷冻球囊导管消融技术治疗心房颤动中期临床随访研究  

Mapping and isolation of pulmonary veins using cryoballoon technique: medium-term clinical outcomes

作　　者：卢春山[1] 张纯[1] 方冬平[1] 徐爱国 郝蓬[1] 何东方[1] 赵林[1] 迟云鹏[1] 马克娟[1] 张瑜[1] 李巧元[1] 信满坤 林璨璨 刘文旭[1] 郭成军[1] LU Chunshan;ZHANG Chun;FANG Dongping;ZHANG Aiguo;HAO peng;HE Dongfang;ZHAO lin;CHI Yunpeng;ZHANG Yu;LI Qiaoyuan;XIN Mankun;LIN Cancan;LIU Wenxu;GUO Chengjun(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029

出　　处：《心肺血管病杂志》2018年第10期907-910,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:评估冷冻球囊行肺静脉隔离(PVI)技术用于心房颤动导管消融的可行性和有效性。方法:入选2014年11月至2018年2月,本科室就诊的40例症状性心房颤动患者(28例阵发性心房颤动,12例持续性心房颤动),采用冷冻球囊技术进行心房颤动消融治疗。结果:共130支肺静脉(130/160, 81.3%)被成功隔离。总术程时间为(167.8±41.6)min,曝光时间为(38.8±15.6)min,总消融时间为(40.8±13.6)min。随访(24±10)个月后,30例(75%)患者成功维持窦律。1例发生心脏穿孔,经心脏修补后康复。结论:冷冻球囊导管消融技术安全有效,可简化PVI操作。Objective： To assess the medium-term clinical outcomes of pulmonary vein isolation（PVI） as an index procedure for atrial fibrillation（AF） ablation using cryoballoon. Methods： Forty consecutive patients [30 male（75%）, mean age（63.8±10.2） years] with symptomatic atrial fibrillation（AF） 28 cases for paroxysmal AF and 12 cases for persistent AF undergoing PVI using the cryoballoon were enrolled. cryoballoon technique in which a microcircular mapping guide wire was introduced into the central lumen of the cryoballoon catheter was used for mapping and ablation.Follow-up was based on outpatient clinic visits including Holter ECGs. Recurrence of atrial tachyarrhythmias（ATas） was defined as a symptomatic or documented episode 430 seconds. Results： A total of 130 PVs（130/160, 81.3%） were identified and successfully isolated. Mean procedural, fluoroscopy and cryoballoon times were（167.8±41.6） minutes,（38.8±15.6） minutes and（40.8±13.6） minutes, respectively. At follow-up [mean（24±10） months], 30（75%） patients were free from atrial fibrillation,1 cases of cardiac perforation and rehabilitation after cardiac repair There was no occurrence of phrenic nerve palsy during the cryoablation in the right superior pulmonary vein. Conclusion： The use of this novel cryoablation technique appears to be safe and effective, and may simplify the ablation procedure for AF.

关 键 词：冷冻球囊 肺静脉隔离 心房颤动 消融 中期随访 

分 类 号：R54[医药卫生—心血管疾病]