射频消融和冷冻消融治疗心房颤动的差异性分析  

作　　者：李威[1] 毛文军 陈超 蔡薇[1] 

机构地区：[1]江苏省苏州市立医院,215000

出　　处：《浙江临床医学》2025年第2期238-240,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨射频消融和冷冻消融在心房颤动治疗中的差异。方法选取2022年3月至2023年2月在我院接受房颤消融治疗的患者,分为射频消融组(RFA)和冷冻消融组(CBA)。比较两组患者基线资料、术后随访1年心律失常复发情况、术中消融肺静脉隔离情况、手术时间、射线剂量、造影剂用量及相关并发症的情况。结果纳入100例患者,RFA组51例,其中持续性房颤26例;CBA组49例,持续性房颤14例。RFA组再发房颤10例,持续性房颤6例;CBA组再发房颤8例,持续性房颤3例。Kaplan-Meier生存分析显示两组房颤复发情况差异无统计学意义(P=0.257)。术中均完成肺静脉隔离,未能转复窦性心律RFA组3例,CBA组1例。手术时间CBA组短于RFA组(P<0.05);射线剂量两组间差异无统计学意义(P>0.05)。造影剂用量CBA组多于RFA组(P=0.016)。穿刺处出血或血肿RFA组2例,CBA组1例;心包积液或填塞RFA组1例,CBA组2例;需植入永久起搏器RFA组2例,CBA组2例;上述并发症比较差异无统计学意义(P>0.05)。膈神经损伤仅见于CBA组。结论射频消融与冷冻消融均能有效隔离双侧肺静脉。冷冻消融手术时间较短,造影剂使用量较多。两组射线使用差异无统计学意义。冷冻消融与射频消融治疗房颤,一年内复发差异无统计学意义。术中及术后并发症两组差异无统计学意义,但膈神经损伤仅见于冷冻消融组。Objective To explore the difference between radiofrequency ablation(RFA)and cryoballoon ablation(CBA)in the treatment of atrial fibrillation(AF).Methods Patients who underwent AF ablation treatment at our hospital from March 2022 to February 2023 were selected and divided into two groups:the RFA group and CBA group.The baseline data,postoperative arrhythmia recurrence within one year,intraoperative pulmonary vein isolation,operation time,radiation dose,contrast dose,and related complications of the two groups were compared.Results A total of 100 patients were included,with 51 cases in the RFA group,including 26 cases of persistent AF;and 49 cases in the CBA group,including 14 cases of persistent AF.In the RFA group,there were 10 cases of recurrent AF,with 6 cases of persistent AF;in the CBA group,there were 8 cases of recurrent AF,with 3 cases of persistent AF.Kaplan-Meier survival analysis showed no statistically significant difference in AF recurrence between the two groups(P=0.257).Pulmonary vein isolation was successfully completed in both groups,with 3 cases in the RFA group and 1 case in the CBA group failing to restore sinus rhythm.The operation time in the CBA group was shorter than that in the RFA group(P<0.05);there was no statistically significant difference in radiation dose between the two groups(P>0.05).The contrast dose in the CBA group was higher than that in the RFA group(P=0.016).There were 2 cases of puncture site bleeding or hematoma in the RFA group and 1 case in the CBA group;1 case of pericardial effusion or tamponade in the RFA group and 2 cases in the CBA group;2 cases requiring permanent pacemaker implantation in the RFA group and 2 cases in the CBA group;there was no statistically significant difference in the above complications.Diaphragmatic nerve injury was only seen in the CBA group.Conclusion Both RFA and CBA can effectively isolate bilateral pulmonary veins.CBA has a shorter operation time and uses more contrast agents.There is no statistically significant difference in radiation

关 键 词：心房颤动 射频消融 冷冻消融 房颤复发 并发症 

分 类 号：R541.75[医药卫生—心血管疾病]