阵发性心房颤动冷消融和热消融的对比研究  

A comparison study of cryoballoon and radiofrequency ablation for paroxysmal atrial fibrillation

作　　者：徐东进 王新华[2] 丁盈英 王秋菊 孙宝贵 XU Dong-jin;WANG Xin-hua;DING Ying-ying;WANG Qiu-ju;SUN Bao-gui(Department of Cardiology,Shanghai Yodak Cardio-Thoracic Hospital,Shanghai 200235,China;Department of Cardiology,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海远大心胸医院心内科,上海市200235 [2]上海交通大学医学院附属仁济医院心内科

出　　处：《中国心血管病研究》2022年第6期560-563,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨冷消融及热消融治疗阵发性心房颤动的临床疗效及安全性。方法 将2018年1月至2020年12月上海远大心胸医院心内科收治的阵发性心房颤动患者104例作为研究对象,按不同消融方式随机分成两组,冷冻球囊消融治疗的51例为冷消融组,冷盐水导管消融53例为热消融组,比较两组的临床效果、并发症,并随访1年观察预后。结果 两组患者治疗前的年龄、性别、体重指数、左心房大小、血压、卒中评分、左心室射血分数均无统计学意义(P>0.05),冷消融组手术时间(98.73±19.90)min较热消融组(124.34±19.32)min短(P<0.001),冷消融组X线透视时间(17.69±2.12)min较热消融组(5.16±1.34)min长(P<0.001)。冷消融组穿刺相关并发症2例,热消融组4例,无统计学差异(P>0.05)。104例患者随访24 h动态心电图1年,冷消融组房颤复发率9.8%,热消融组复发率11.3%(P>0.05)。结论 冷消融阵发性心房颤动疗效不劣于热消融,手术并发症也无明显差异。冷消融操作相对简单,手术时间短,患者舒适度高,对于阵发性房颤患者,可作为一种优选治疗策略。Objective To investigate the clinical safety and effectiveness of cryoballoon ablation and radiofrequency ablation in paroxysmal atrial fibrillation. Methods A totle of 104 patients with paroxysmal atrial fibrillation in Shanghai Yodak Cardio-Thoracic Hospital from January 2018 to December 2020 were involved in the study. According to the different surgical methods,the patients were divided into two groups: 51 cases in the cryoballoon ablation group and 53 cases in conventional radiofrequency ablation group. The clinical effectiveness,complications, and prognosis were compared. Results Before the treatment, the patients of the two groups showed no statistical significance in age, sex, body mass index, left atrial diameters, blood pressure, stroke scores,and left ventricular EF(P>0.05). The procedure time of cryoablation group(98.73±19.90) min was significantly shorter than radiofrequency ablation group(124.34±19.32) min(P<0.001). The cryoablation group(17.69±2.12)min took longer fluoroscopy time than radiofrequency ablation group(5.16 ± 1.34) min(P<0.001). The puncture sites related complications after the procedures had no statistical significance(P>0.05). The follow up visits after one year showed that the recurrence rate for cryoablation group was 9.8% and the radiofrequency ablation group was 11.3%(P>0.05). Conclusions The effectiveness of cryoballoon ablation is non inferior to radiofrequency ablation and the procedural complications have no significant difference. The cryoballoon ablation is easier to operate with shorter procedural time and higher patient comfort. For paroxysmal atrial fibrillation, cryoballoon ablation is a promising alternative technique and could be used as a preferred treatment strategy.

关 键 词：冷消融 热消融 心房颤动 

分 类 号：R541.7[医药卫生—心血管疾病]