Cryoballoon ablation of persistent atrial fibrillation for de novo pulmonary vein isolation: a single-center follow-up study
Zhong-Jing CAO1
Xiao-Gang GUO2
Qi SUN2
Yan-Qiao CHEN2
Hai-Yang XIE2
Jian-Du YANG2
Hui-Qiang WEI3
Jia-Hui LI2
Jian MA2
1.Department of Cardiology,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,School of Medicine UESTC,Chengdu,China;State Key Laboratory of Cardiovascular Disease,Arrhythmia Center,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China2.State Key Laboratory of Cardiovascular Disease,Arrhythmia Center,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China3.Department of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Science,Guangzhou,China
摘要：BACKGROUND Pulmonary vein isolation (PVI) alone for persistent atrial fibrillation (PersAF) remains controversial. The characteristics of cryoballoon ablation (CBA) to treat PersAF and the blanking period recurrence are underreported.METHODS This study retrospectively analyzed patients with PersAF undergoing second-generation CBA for de novo PVI. The post-procedural efficacy and survival analysis were compared between patients with different PersAF durations. The mul-tivariate Cox regression analysis was used to detect the risk factors for recurrence. Early and long-term recurrence were analyzed relative to each other. RESULTS A total of 329 patients were enrolled, with a median PersAF duration of 4.0 months (interquartile range: 2.0–12.0 months); 257 patients (78.1％) were male. Kaplan-Meier analysis of freedom from atrial fibrillation recurrence at 12, 24, and 30 months showed 71.0％, 58.5％, and 54.9％, respectively. Early PersAF had a relatively favorable survival rate and a narrow P-wave duration of restoring sinus rhythm compared with that of PersAF lasting more than three months (P < 0.05). The multivariate Cox regression analysis revealed that PersAF duration and left atrial anteroposterior diameter ≥ 42 mm were the risk factors for atrial fibrillation recurrence after CBA [hazard ratio (HR) = 1.89, 95％ CI: 1.01–1.4, P = 0.042; HR = 3.6, 95％ CI: 2.4–5.4, P < 0.001, re-spectively]. The blanking period recurrence predicted the long-term recurrence (P < 0.0001). CONCLUSIONS CBA of PersAF had safety and efficacy to reach de novo PVI. The PersAF duration and left atrial size were risk factors for atrial fibrillation recurrence after CBA. Blanking period recurrence was associated with long-term recurrence.
机标关键词：isolationstudyablationatrialcryoballoonfibrillationfollow-upnovo
论文发表日期：2022-10-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 725-733 )