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【文摘发布】经导管冷冻消融肺静脉治疗阵发性
Wendel Moreira, MD*,3, Randy Manusama, MD*,3, Carl Timmermans, MD, PhD, FACC*,1, Benoit Ghaye, MD, Suzanne Philippens, RN*, Hein J.J. Wellens, MD, PhD, FACC,2 and Luz-Maria Rodriguez, MD, PhD, FACC*,*,1
* Department of Cardiology, Academic Hospital Maastricht, Maastricht, the Netherlands
Department of Medical Imaging, University Hospital of Liége, Liége, Belgium
Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands.
Objectives: This study was designed to evaluate the long-term effect of segmental pulmonary vein (PV) cryoablation in patients with recent-onset paroxysmal atrial fibrillation (PAF).
Background: Patients with PAF have more triggers to initiate and less substrate to sustain atrial fibrillation (AF). Elimination of the potential initiators alone may be sufficient to abolish the arrhythmia.
Methods: Patients with PAF were prospectively recruited from July 2001 to July 2005. If the triggers for AF were identified, PV cryoisolation of the arrhythmogenic vein was performed. Otherwise, all PVs were isolated.
Results: Seventy patients with minimal or no heart disease (54 men; age 40 ± 10 years) were enrolled. The duration of AF was 4 ± 1 year. The left ventricular ejection fraction and left atrial size were 59 ± 8% and 41 ± 5 mm, respectively. An arrhythmogenic PV was found in 10 patients (14%). Complications occurred in 3 patients (4%). No PV stenosis or esophageal injury was detected during a mean follow-up of 33 ± 15 months. Thirty-four patients (49%) achieved complete success (no AF and no antiarrhythmic drugs [AAD]); 15 patients (22%) had no recurrences with AAD; and 8 patients (11%), still with sporadic bursts of AF, improved >50% with AAD. Overall, 82% of the patients benefited from the procedure. Patients in whom the arrhythmogenic PV was identified and isolated had no recurrences.
Conclusions: Pulmonary vein cryoisolation is effective in 82% of patients with recent-onset PAF during a mean follow-up of 33 ± 15 (range 15 to 60) months. If the arrhythmogenic PV is identified and isolated, the long-term outcome is excellent, indicating no need to isolate all PVs.
J Am Coll Cardiol, 2008; 51:850-855 这个感兴趣,我喜欢心律失常,认领!24小时内完成!
OK!
Long-Term Follow-Up After Cryothermic Ostial Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation
肺静脉口冷冻隔离治疗阵发性房颤后的长期随访
Wendel Moreira, MD*,3, Randy Manusama, MD*,3, Carl Timmermans, MD, PhD, FACC*,1, Benoit Ghaye, MD, Suzanne Philippens, RN*, Hein J.J. Wellens, MD, PhD, FACC,2 and Luz-Maria Rodriguez, MD, PhD, FACC*,*,1
* Department of Cardiology, Academic Hospital Maastricht, Maastricht, the Netherlands
Department of Medical Imaging, University Hospital of Liége, Liége, Belgium
Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands.
Academic Hospital Maastricht, 心脏病学科, Maastricht, the Netherlands; 医学影像科, University Hospital of Liége, Liége, Belgium; Maastricht心血管研究所, Maastricht, the Netherlands
Objectives: This study was designed to evaluate the long-term effect of segmental pulmonary vein (PV) cryoablation in patients with recent-onset paroxysmal atrial fibrillation (PAF).
目的:本研究目的在于评估节段性肺静脉消融对于新近发作的阵发性房颤(PAF)患者的长期疗效
Background: Patients with PAF have more triggers to initiate and less substrate to sustain atrial fibrillation (AF). Elimination of the potential initiators alone may be sufficient to abolish the arrhythmia.
背景AF病人有更多的电触发点,而较少维持房颤的基础因素.因此,消除其电触发启动点,也许对于治疗这种心律失常很有效.
Methods: Patients with PAF were prospectively recruited from July 2001 to July 2005. If the triggers for AF were identified, PV cryoisolation of the arrhythmogenic vein was performed. Otherwise, all PVs were isolated.
方法:我们于2001年到2005年前瞻性地纳入了病例.如果患者AF的电冲动触发得以确定,即予相应致心律失常的肺静脉冷冻隔离.否则予全肺静脉隔离
Results: Seventy patients with minimal or no heart disease (54 men; age 40 ± 10 years) were enrolled. The duration of AF was 4 ± 1 year. The left ventricular ejection fraction and left atrial size were 59 ± 8% and 41 ± 5 mm, respectively. An arrhythmogenic PV was found in 10 patients (14%). Complications occurred in 3 patients (4%). No PV stenosis or esophageal injury was detected during a mean follow-up of 33 ± 15 months. Thirty-four patients (49%) achieved complete success (no AF and no antiarrhythmic drugs [AAD]); 15 patients (22%) had no recurrences with AAD; and 8 patients (11%), still with sporadic bursts of AF, improved >50% with AAD. Overall, 82% of the patients benefited from the procedure. Patients in whom the arrhythmogenic PV was identified and isolated had no recurrences.
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作者:admin@医学,生命科学 2011-05-02 17:14
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